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反复发作的缺血性卒中

徐曼曼 徐运

徐曼曼, 徐运. 反复发作的缺血性卒中[J]. 协和医学杂志, 2018, 9(3): 285-288. doi: 10.3969/j.issn.1674-9081.2018.03.018
引用本文: 徐曼曼, 徐运. 反复发作的缺血性卒中[J]. 协和医学杂志, 2018, 9(3): 285-288. doi: 10.3969/j.issn.1674-9081.2018.03.018
Man-man XU, Yun XU. Recurrent Ischemic Stroke[J]. Medical Journal of Peking Union Medical College Hospital, 2018, 9(3): 285-288. doi: 10.3969/j.issn.1674-9081.2018.03.018
Citation: Man-man XU, Yun XU. Recurrent Ischemic Stroke[J]. Medical Journal of Peking Union Medical College Hospital, 2018, 9(3): 285-288. doi: 10.3969/j.issn.1674-9081.2018.03.018

反复发作的缺血性卒中

doi: 10.3969/j.issn.1674-9081.2018.03.018
基金项目: 

江苏省科技厅医学重点项目 BE2016610

江苏省医学重点学科 ZDXKA2016020

详细信息
    通讯作者:

    徐运 电话:025-68182212, E-mail:xuyun20042001@aliyun.com

  • 中图分类号: R743.3

Recurrent Ischemic Stroke

More Information
  • 摘要: 部分患者对抗血小板药物表现为低反应性或无反应, 接受抗血小板规范治疗后仍发生心脑血管事件。本例患者为63岁女性, 长期服用阿司匹林和氯吡格雷, 多次出现肢体乏力, 行头颅磁共振扫描均提示急性脑梗死。后经血小板聚集试验、闭合试验及基因检测证实, 该患者存在阿司匹林和氯吡格雷低反应性。改服西洛他唑, 随访1年余, 未再发生心脑血管事件。
  • 图  1  患者头部磁共振成像及磁共振血管成像(箭头)

    A.左侧胼胝体体部及膝部高信号, 提示急性脑梗死; B.左侧大脑前动脉粗细不均; C.第一次右侧半卵圆中心陈旧性脑梗死; D.第二次右侧丘脑陈旧性脑梗死

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    [4] Lin MP, Ovbiagele B, Markovic D, et al. Association of Secondhand Smoke with Stroke Outcomes[J]. Stroke, 2016, 47:2828-2835. doi:  10.1161/STROKEAHA.116.014099
    [5] Fu J, Tang J, Yang J, et al. Adding computed tomography and transcranial Doppler findings to the ABCD2 score to predict long-term risk of stroke after transient ischaemic attack or minor stroke[J]. Eur J Neurol, 2015, 22:520-526. doi:  10.1111/ene.12606
    [6] Chadha DS, Sumana B, Karthikeyan G, et al. Prevalence of aspirin resistance in Asian-Indian patients with stable coronary artery disease[J]. Catheter Cardiovasc Interv, 2016, 88:E126-E131. doi:  10.1002/ccd.25420
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    [8] Cattaneo M, Cerletti C, Harrison P, et al. Recommendations for the Standardization of Light Transmission Aggregometry:A Consensus of the Working Party from the Platelet Physiology Subcommittee of SSC/ISTH[J]. J Thromb Haemost, 2013, 11:1183-1189. doi:  10.1111/jth.12231
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    [12] Lin YJ, Li JW, Zhang MJ, et al. The association between CYP2C19 genotype and of in-stent restenosis among patients with vertebral artery stent treatment[J]. CNS Neurosci Ther, 2014, 20:125-130. doi:  10.1111/cns.12173
    [13] Pan Y, Chen W, Xu Y, et al. Genetic Polymorphisms and Clopidogrel Efficacy for Acute Ischemic Stroke or Transient Ischemic Attack:A Systematic Review and Meta-Analysis[J]. Circulation, 2017, 135:21-33. doi:  10.1161/CIRCULATIONAHA.116.024913
    [14] Wang Y, Zhao X, Lin J, et al. Association Between CYP2C19 Loss-of-Function Allele Status and Efficacy of Clopidogrel for Risk Reduction Among Patients With Minor Stroke or Transient Ischemic Attack[J]. JAMA, 2016, 316:70-78. doi:  10.1001/jama.2016.8662
    [15] Anderson CD, Biffi A, Greenberg SM, et al. Personalized approaches to clopidogrel therapy:are we there yet?[J].Stroke, 2010, 41:2997-3002. doi:  10.1161/STROKEAHA.110.594069
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出版历程
  • 收稿日期:  2018-01-10
  • 刊出日期:  2018-05-30

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