摘要
脑卒中是我国致残、致死性最高的疾病之一,其中缺血性脑卒中占比约80%,老年人口中比例更高。血栓导致的脑血管闭塞事件是缺血性脑卒中发生的主要原因之一,近年来机械取栓在急性缺血性脑卒中的成功应用提升了人们对血栓的直接认识。血栓的病理学成分主要包括血小板、红细胞、白细胞、纤维蛋白、血管性血友病因子(VWF)等,血栓成分通常与卒中病因有关,研究显示大动脉粥样硬化性血栓比其他病因含有更多的红细胞。不同血栓成分在CT、MRI及数字剪影血管造影等影像学检查中存在不同特点,同时静脉溶栓、机械取栓对不同成分血栓的治疗效果不同。本文对血栓的病理成分与卒中病因、影像学及治疗方式的关系进行综述,旨在指导脑卒中的治疗和二级预防。
Stroke is one of the most disabling and fatal diseases in China,with ischemic stroke accounting for about 80%and even higher in the elderly.Thrombosis-induced cerebrovascular occlusive events are one of the main causes of ischemic stroke.The successful application of mechanical thrombectomy in acute ischemic strokes in recent years has enhanced people′s understanding of thrombi.The pathological components of thrombi primarily include platelets,red blood cells(RBCs),white blood cells(WBCs),fibrin,and von Willebrand factor(VWF).The composition of a thrombus is often associated with the etiology of the stroke.Studies have shown that thrombi resulting from large artery atherosclerosis contain a higher proportion of RBCs than those from other causes.Different thrombus components exhibit distinct characteristics in imaging modalities such as CT,MRI and digital subtraction angiography.At the same time,the therapeutic efficacy of thrombolytic therapy and mechanical thrombectomy varies with thrombus components.This article provides a comprehensive review of the relationship between the pathological components of thrombi and stroke etiology,imaging and treatment modalities,aiming to guide the treatment and secondary prevention of stroke.
作者
李冉
刘俊汝
张广宇
袁海成
Li Ran;Liu Junru;Zhang Guangyu;Yuan Haicheng(Clinical Medical School of Shandong Second Medical University,Weifang 261053,Shandong Province,China;Department of Neurology,Qingdao Central Hospital of University of Health and Rehabilitation Sciences,Qingdao Central Medical Group,Qingdao 266042,Shandong Province,China)
出处
《中华老年多器官疾病杂志》
2024年第9期717-720,共4页
Chinese Journal of Multiple Organ Diseases in the Elderly
关键词
脑梗死
血栓成分
血小板
红细胞
ischemic stroke
thrombus component
blood platelet
erythrocyte
