- 期刊
如何預測缺血性中風的復發風險
How to Evaluate the Risk of Recurrence After Acute Ischemic Stroke?
摘要
缺血性中風發生以後，一部分的病人會發生缺血性中風復發，此一現象的發生與病人的一些危險因子有關，藉由危險因子的評估得以預測在缺血性中風復發的可能性。具有多重危險因子的病人，可使用預測模式進行評估。對於發生暫時性腦缺血後的短期復發中風機率的評估，以ABCD^2最為簡單常用，但此模式對於高風險與低風險族群的鑑別力不足，其衍生的ABCD^3-I與RRE-90則有較好之效果。腦中風發生後的長期預測，則可使用Essen Stroke Risk Score、Stroke Prediction Instrument-II等量測方式。對於接受靜脈血栓溶解治療的病人，急性復發機率尚未確定，而接受動脈內血栓移除治療的病人，我們近期的研究顯示其復發之機率則可能與血管狀況和瓣膜性心臟病有關。
並列摘要
Recurrence of ischemic stroke may occur in the short term or long term after the index event. The risk of recurrence could be determined by the presence of certain risk factors. To predict the short term risk of ischemic stroke development after a transient ischemic attack, the ABCD^2 scoring system is the most well known model, which is easy to use. However, studies had shown that it could not effectively differentiate the patients with high risk of recurrence from the ones with lower risk. ABCD^3-I, which was derived from ABCD^2, along with RRE-90, are more effective in identifying the patients with higher risk. For the evaluation of long term ischemic stroke recurrence, Essen Stroke Recurrence Scale(ESRS) and Stroke Prediction Instrument-II (SPI-II) are both effective. The risk of early recurrence of ischemic stroke in patients receiving intravenous thrombolysis and endovascular thrombectomy are still not well determined. Our recent study suggested that the risk of recurrence after endovascular thrombectomy may be related to vascular conditions and the presence of valvular heart disease.