急性缺血性脑卒中抗血小板药物治疗与脑微出血的相关性研究-神经病学专业论文.docxVIP

万方数据 万方数据 目 录 中文摘要································································································1 英文摘要································································································5 英文缩写·······························································································11 研究论文 急性缺血性脑卒中抗血小板药物治疗与脑微出血的相关性研究 前言·······························································································12 材料与方法····················································································13 结果·······························································································16 附图·······························································································19 附表·······························································································21 讨论·······························································································24 结论·······························································································33 参考文献························································································34 综述 脑微出血在脑血管病领域的研究进展···········································39 致谢······································································································51 个人简历·······························································································52 中 中 文 摘 要 PAGE 10万方数据 PAGE 10 万方数据 急性缺血性脑卒中抗血小板药物治疗与脑微出血的相关性研究 摘 要 目的：脑微出血（cerebral microbleeds，CMBs）通常并无明显的临床 表现,只有在影像学或尸检上才可被发现的细小出血病变，其本质为渗漏 到血管壁外部并通过巨噬细胞分解的血液代谢产物[1]。有研究发现 CMBs 的数量与血管壁的严重损害程度相关联[2]，所以它在一定程度上可以用来 预测脑出血的发生[3]。然而目前关于 CMBs 与缺血性卒中出血转化、溶栓、 抗血小板及抗凝治疗的出血风险等热点问题尚存在争议。最近中国的 CHANCE（Clopidogrel and Aspirin versus Aspirin Alone for the Treatment of High~risk Patients with Acute Nondisabling Cerebrovascular Event）研究 明确指出小卒中及短暂性脑缺血发作（Transient ischemic attack，TIA）患 者在早期使用双联抗血小板药物可以降低 3 个月内的卒中发生率，但是该 研究并未对受试者进行卒中病因分型，也未明确指出抗血小板治疗方案的 不同选择对于 CMBs 发生状况的影响。因此，本研究以缺血性脑