可溶性粘附分子与缺血性卒中

细胞粘附分子在动脉粥样硬化形成和缺血／再灌注损伤中起重要作用，在有缺血性卒中危险因素的人群和缺血性卒中病人中均发现有可溶性粘附分子含量的变化，定量检测其血清含量对于探讨缺血性卒中发病机制和指导临床治疗有潜在的价值。     

可溶性粘附分子与缺血性卒中

细胞粘附分子在动脉粥样硬化形成和缺血／再灌注损伤中起重要作用，在有缺血性卒中危险因素的人群和缺血性卒中病人中均发现有可溶性粘附分子含量的变化，定量检测其血清含量对于探讨缺血性卒中发病机制和指导治疗有潜在的价值。     

牙周病与缺血性卒中的相关性及其可能机制

大量流行病学研究表明,牙周病与缺血性卒中有一定的相关性,可能是其独立危险因素,但具体机制尚不完全清楚。文章对牙周病与缺血性卒中的流行病学研究以及可能的作用机制进行了综述。     

青年人缺血性卒中159例危险因素和颈动脉粥样硬化的研究

目的探讨青年人缺血性卒中的危险因素及与颈动脉粥样硬化的关系。方法调查159例青年人缺血性卒中患者的危险因素及应用彩色多普勒超声检测其颈动脉。结果青年人缺血性卒中发病的危险因素主要有高血压、糖尿病、血脂异常、吸烟、酗酒及既往心脑血管病史。病例组双侧颈动脉内中膜厚度（IMT）显著高于对照组，再发脑梗死组较初发脑梗死组中软斑比例高。结论动脉硬化是青年人缺血性卒中的主要发病原因，卒中预防应尽早开始，颈动脉B超有助早期诊断。     

老年缺血进展性卒中危险因素探讨

进展性卒中（stroke in progression，SIP）约占缺血性卒中患者的30％。明确SIP的危险因素及发病机制是非常重要的。本文对近3年来我院收治的46例老年SIP患者的临床资料进行回顾性分析，并和同期住院的46例一般缺血性卒中患者进行对照研究，以探讨卒中进展的危险因素。     

缺血性卒中与心房颤动

心房颤动（房颤）是一类以无序的心房活动和不规则的心室反应为主要特点的心律失常疾病。众所周知，房颤是缺血性（脑）卒中重要的独立危险因素之一，理解其与缺血性卒中的内在关联，早期筛查和/或干预，同时对房颤的危险因素进行管理，将有益于缺血性卒中的一级预防。     

缺血性卒中相关性卵圆孔未闭的介入治疗

卵圆孔未闭是缺血性卒中的一个新的危险因素，但其具体机制仍不明，许多相关问题尚需进一步探讨。通过对相关文献进行比较，进一步肯定了卵圆孔未闭与缺血性或不明原因的卒中之间有很强的联系。房间隔瘤伴发卵圆孔未闭是脑梗死的危险因素。经皮导管卵圆孔未闭封堵术的应用前景看好，但还需要进行进一步的前瞻性研究。     

脂蛋白(a)与缺血性卒中

血脂异常是一个公认的缺血性卒中危险因素。作为血脂的重要组成成分,脂蛋白(a)是一种首先被发现存在于动脉粥样硬化斑块内的类似低密度脂蛋白胆固醇的含脂体。研究显示,脂蛋白(a)通过多种机制参与动脉粥样硬化和血栓形成,进而引发心脑血管病。明确其与缺血性卒中以及其他血管性危险因素之间的联系,可为缺血性卒中的早期预防和治疗提供参...     

缺血性卒中二级预防的研究进展

缺血性卒中的二级预防指对已有脑缺血症状如短暂性脑缺血发作或缺血性卒中发作史的病人给予干预措施，以降低卒中发作和复发的危险。除对发生缺血性卒中的危险因素特别是与卒中复发有关的危险因素进行识别和纠正外，外科手术、抗释药、抗血小板药物已广泛用于卒中的预防。文章就缺血性卒中二级预防的研究进展作了综述。     

肿瘤患者的缺血性卒中

缺血性卒中是恶性肿瘤的重要并发症之一。肿瘤患者缺血性卒中的病因和发病机制非常复杂,既包括高血压、糖尿病、高脂血症等传统血管危险因素,又包括与肿瘤病理生理学状态相关的危险因素,例如高凝状态、肿瘤栓子、血栓性心内膜炎等。此外,与肿瘤相关的各种治疗方法,例如放疗、化疗和内分泌治疗,也会增高缺血性卒中的风险。由于病因和发病机制的复杂性,肿瘤患者缺血性卒中的治疗方法也与常规有所不同,因此,明确病因并选取针对性的治疗方法对于肿瘤患者缺血性卒中的防治极为关键。随着肿瘤患者生存率的提高,肿瘤患者缺血性卒中也越来越受到重视。文章对肿瘤患者缺血性卒中的病因、发病机制和治疗的研究进展进行了综述。     

Epidemiology and risk factors of cerebral ischemia and ischemic heart diseases: similarities and differences

Cerebral ischemia and ischemic heart diseases, common entities nowadays, are the main manifestation of circulatory diseases. Cardiovascular diseases, followed by stroke, represent the leading cause of mortality worldwide. Both entities share risk factors, pathophisiology and etiologic aspects by means of a main common mechanism, atherosclerosis. However, each entity has its own particularities. Ischemic stroke shows a variety of pathogenic mechanisms not present in ischemic heart disease. An ischemic stroke increases the risk of suffering a coronary heart disease, and viceversa. The aim of this chapter is to review data on epidemiology, pathophisiology and risk factors for both entities, considering the differences and similarities that could be found in between them. We discuss traditional risk factors, obtained from epidemiological data, and also some novel ones, such as hyperhomocisteinemia or sleep apnea. We separate risk factors, as clasically, in two groups: nonmodifiables, which includes age, sex, or ethnicity, and modifiables, including hypertension, dyslipidemia or diabetis, in order to discuss the role of each factor in both ischemic events, ischemic stroke and coronary heart disease.     

高尿酸血症与缺血性卒中及其危险因素

高尿酸血症与高血压、糖尿病、高脂血症、肥胖等卒中危险因素均有显著相关性,且与缺血性卒中及其预后相关.文章对高尿酸血症与卒中危险因素的相关性及其对缺血性卒中预后的影响进行了综述.     

前循环与后循环缺血性卒中的危险因素比较——回顾性病例系列研究

目的 探讨前循环与后循环缺血性卒中血管危险因素的差异.方法 制定统一的青岛市缺血性卒中诊治现状调查表,回顾性收集青岛市、县两级具备影像学检查设施(CT或MRI)的11家医院神经内科2008年6月至2009年2月期间连续就诊的943例急性缺血性卒中患者资料,分析前循环和后循环缺血性卒中患者的危险因素.结果 单变量分析显示...     

早发性动脉粥样硬化性缺血性卒中的危险因素

青年缺血性卒中的病因复杂多样，但仍以动脉粥样硬化性血栓栓塞为主。除传统危险因素，如高血压、糖尿病、吸烟、肥胖等外，近年来新发现的危险因素，如炎症、高同型半胱氨酸血症、脂蛋白（a）增高、抗磷脂抗体阳性等也都是早发性动脉粥样硬化的危险因素。文章综述了这些危险因素在青年缺血性卒中发病中的作用。     

Analyse des comorbidités chez les patients hospitalisés pour un accident vasculaire cérébral ischémique et leurs influences sur la létalité

ObjectivesThe aim of the study consists of analyzing the comorbidities of acute ischemic stroke and those influencing its hospital lethality.MethodsWe considered patients from Wallonia aged 25 years or more and admitted to a Belgian hospital for an acute ischemic stroke in 2013 and 2014. The analyzed medico-administrative data are taken from the Minimum Hospital Summary. A factorial correspondence analysis (FCA) was used to demonstrate the comorbidities profiles. A logistic regression was used to analyse the comorbidities influencing hospital lethality by ischemic stroke.ResultsThe stroke risk factors vary according to the age. Cardiac problems are more common in older people aged 85 years or more. High blood pressure, hypercholesterolemia and diabetes are more present between 65- and 84-year-olds. Overweight is more present between 55 and 74-year-olds. People who are addicted to alcohol or tobacco are often 65 years or younger. The logistic regression showed that age and heart problems are the risk factors that increase lethality. However there is a lethality diminution in the presence of high blood pressure, hypercholesterolemia, overweight and addiction to alcohol or tobacco.ConclusionThis study demonstrates that medico-administrative databases and factorial statistical methods are perfectly adapted to confirm the ischemic stroke risk factors. This type of study will allow to target with more precision the secondary and tertiary prevention actions of stroke.     

Vertebral artery hypoplasia as an independent risk factor of posterior circulation atherosclerosis and ischemic stroke

Vertebral artery hypoplasia (VAH) is a frequent anatomical variation of vertebral arteries, with emerging evidence suggesting that it contributes to posterior circulation ischemia. However, the relationship between VAH and ischemic stroke remains unknown. Hence, this study aimed to determine the prevalence of VAH in patients diagnosed with acute ischemic stroke who were followed up in a neurology clinic and to determine if it can potentially be a risk factor for atherosclerotic stenosis in vertebrobasilar circulation.This retrospective study included 609 patients diagnosed with acute ischemic stroke between January 1, 2019 and January 1, 2020. Demographic of patients, risk factors, radiological and clinical characteristics were evaluated.Posterior circulation was very common in patients with VAH, and the most common locations of atherosclerotic stenosis were V1 and V4 segments of the vertebral artery and the middle segment of basilar artery. Analysis of the risk factors for atherosclerotic stenosis in patients with posterior circulation acute ischemic stroke suggested that VAH was an independent risk factor.Findings of the study suggest that VAH pre-disposes atherosclerotic stenosis in vertebrobasilar circulation, although its mechanism remains unknown. Hemodynamic parameters associated with atherosclerosis could not be measured in vivo. Thus, to better understand the underlying mechanism, conducting studies that examine blood flow parameters with high-resolution magnetic resonance angiography in patients diagnosed with acute cerebral ischemia patients with VAH is warranted.     

高龄人群(≥80岁)缺血性卒中的危险因素

高龄人群(≥80岁)缺血性卒中的危险因素与其他人群(＜80岁)不尽相同.与其他年龄人群相比,高龄人群女性缺血性卒中的发病率更高,传统危险因素以心房颤动和高血压更为多见,而糖尿病、高脂血症、吸烟和饮洒则较为少见,心力衰竭、缺血性心脏病和高肌酐水平是否会增高其缺血性卒中风险尚不确定.总体而言,传统危险因素对高龄人群缺血性卒中的作用还有待进一步研究.     

In the search for stroke genes: a long and winding road

In spite of a significant improvement in control of numerous predisposing risk factors, stroke remains a major health problem and a common cause of death and disability in our societies. Genetic predisposition to stroke development exists and has been documented in both animal models and in humans. However, a precise definition of genetic factors responsible for common forms of stroke is still lacking, mainly due to its complex nature, the confounding presence of other predisposing risk factors, and the genetic heterogeneity of human populations. In contrast, important breakthroughs have been reached for monogenic forms of stroke, such as cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL).An animal model of stroke, the stroke-prone spontaneously hypertensive rat, has provided valuable information on genetic factors involved in stroke predisposition. Among them, the gene-encoding atrial natriuretic peptide has been identified as a stroke gene in both the stroke-prone spontaneously hypertensive rat and, subsequently, in two different human populations. In particular, structural alterations of the gene are consistently present in diseased individuals, suggesting an important role of mutation-dependent mechanisms in stroke predisposition. Finally, the recent use of intermediate disease phenotypes provides a reductionist approach that may contribute to important accumulating information on genes contributing to cerebrovascular accidents.     

The Multiple Causes of Stroke in Atrial Fibrillation: Thinking Broadly

Atrial fibrillation (AF) is numerically the most important risk factor for stroke. It is well established that patients with AF have a 5-fold increased risk of stroke relative to those without and that anticoagulation reduces the risk of stroke by approximately two-thirds. Definitively attributing the mechanism of an individual stroke to AF is more problematic, however. In fact, there is no way to reliably establish the etiology of any ischemic infarction. This necessitates screening for all potential stroke risk factors and treating accordingly. The pattern of infarction is often used to classify the presumed mechanism of infarction as thrombotic or embolic, although even this is approach is based on association and increasingly is recognized as not completely reliable. Furthermore, it should not dictate management—patients with perforating arterial territory infarcts with AF also require and benefit from anticoagulation. Likewise, if other potential embolic sources beyond AF are identified, anticoagulation remains the standard of care. The traditional conceptual model of the mechanistic link between AF and cardioembolic infarction is likely oversimplified. Long-term cardiac rhythm recording studies indicate an inconsistent temporal relationship between AF and infarction. This suggests that cardioembolic stroke in patients with AF may result from the underlying atrial cardiopathy, rather than the rhythm disturbance leading to atrial stasis and thromboembolism. We reviewed traditional and current concepts, as well as evidence for the role of AF in ischemic stroke.     

Is cirrhosis associated with lower odds of ischemic stroke: A nationwide analysis?

AIM To determine the association between cirrhosis and ischemic stroke in a large nationally representative sample. METHODS A retrospective cross-sectional study of all hospitalized patients during 2012 and 2013 in the United States was performed using the National Inpatient Sample database. Hospitalizations with acute stroke, cirrhosis and other risk factors were identified using ICD-9-CM codes.RESULTS There were a total of 72082638 hospitalizations in the United States during the years 2012 and 2013. After excluding hospitalizations with missing demographic variables, that there were a total of 1175210(1.6%) out of these were for acute ischemic stroke. Cirrhosis was present among 5605(0.4%) cases of ischemic stroke. Mean age among the cirrhotic and non-cirrhotic groups with ischemic stroke were 66.4 and 70.5 years, respectively. Prevalence of risk factors among the two groups was also calculated. After adjusting for various known risk factors the odds of having an ischemic stroke(OR = 0.28, P 0.001) were 72% lower in cirrhotics compared to non-cirrhotics.CONCLUSION Our study suggests that in a large, nationally representative sample of the United States population, cirrhosis is associated with a lower likelihood of stroke.