FOLLOWUS
1.Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing (100700),China
2.Department of Rehabilitation, Dongfang Hospital,Beijing University of Chinese Medicine, Beijing (100078), China
3.Department of Emergency, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing (100010),China
4.Department of Neurology, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou (510120), China
5.Department of Neurology, the First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou (450000),China
6.Department of Neurology, the Affiliated Hospital of Changchun University of Chinese Medicine, Changchun(130017), China
7.Department of Neurology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing(100700), China
8.Department of Neurology, Taiyuan Hospital of Traditional Chinese Medicine, Taiyuan (140107), China
Prof. XIE Yan-ming, E-mail: ktzu2018@163.com
纸质出版日期:2022-06-01,
网络出版日期:2022-03-08,
录用日期:2021-05-16
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Yang GAO, Yan-ming XIE, Gui-qian WANG, 等. 中国中医院非心源性缺血性脑卒中患者的发病及复发特点[J]. Chinese Journal of Integrative Medicine, 2022,28(6):492-500.
Yang GAO, Yan-ming XIE, Gui-qian WANG, et al. Onset and Recurrence Characteristics of Chinese Patients with Noncardiogenic Ischemic Stroke in Chinese Medicine Hospitals[J]. Chinese Journal of Integrative Medicine, 2022,28(6):492-500.
Yang GAO, Yan-ming XIE, Gui-qian WANG, 等. 中国中医院非心源性缺血性脑卒中患者的发病及复发特点[J]. Chinese Journal of Integrative Medicine, 2022,28(6):492-500. DOI: 10.1007/s11655-022-3306-4.
Yang GAO, Yan-ming XIE, Gui-qian WANG, et al. Onset and Recurrence Characteristics of Chinese Patients with Noncardiogenic Ischemic Stroke in Chinese Medicine Hospitals[J]. Chinese Journal of Integrative Medicine, 2022,28(6):492-500. DOI: 10.1007/s11655-022-3306-4.
目的:
2
描述中国非心源性缺血性脑卒中患者的发病和复发特征.
方法:
2
在2016年 11月3日至2019年2月17日期间
本研究对7个临床中心的2558例患者进行了前瞻性、多中心的注册登记研究. 使用问卷调查收集包括中医证候、体质及卒中相关的影响因素
研究的主要结局指标为卒中复发.
结果:
2
共有327例 (12.78%) 患者出现复发事件. 男性1681例 (65.72%)
平均年龄为63.33±9.45岁; 1741 (68.06%) 例患者为首次缺血性卒中; 1772 (69.27%) 例患者患有高血压病
1640 (64.11%) 例患者存在血脂异常
1595 (62.35%) 例患者卒中病因TOAST分型为小动脉闭塞性. 中医气虚体质为1271例 (49.69%) 、血瘀体质为1227例 (47.97%) ; 中医证候辨证为血瘀证为1303例 (50.94%) 、痰湿证为1280例 (50.04%) 、气虚证为1012例 (39.56%) . 1033 (40.38%) 例患者颅内动脉处于狭窄状态
478 (18.69%) 例患者颈动脉处于狭窄状态; 1508 (41.36%) 例患者的颈动脉斑块为混合型; 41.09% 的人群糖化血红蛋白水平 (HbA1c) 处于异常状态.
结论:
2
卒中复发在小动脉闭塞性卒中中不能被忽视; 高血压、血脂异常、HbA1c异常、颅内动脉狭窄和颈动脉斑块在脑卒中患者中更为常见; 痰湿证、血瘀证及气虚体质、血瘀体质仍是脑卒中的主要表现.
Objective:
2
To delineate the onset and recurrence characteristics of noncardiogenic ischemic stroke patients in China.
Methods:
2
A prospective
multicenter and registry study was carried out in 2
558 patients at 7 representative clinical sub-centers during November 3
2016 to February 17
2019. A questionnaire was used to collect information of patients regarding CM syndromes and constitutions and associated risk factors. Additionally
stroke recurrence was defined as a primary outcome indicator.
Results:
2
A total of 327 (12.78 %) patients endured recurrence events
1
681 (65.72%) patients were men
and the average age was 63.33±9.45 years. Totally 1
741 (68.06%) patients suffered first-ever ischemic stroke
1
772 (69.27%) patients reported to have hypertension
and 1
640 (64.11%) of them reported dyslipidemia
1
595 (62.35%) patients exhibited small-artery occlusion by The Trial of Org 10172 in Acute Stroke Treatment (TOAST) classification. Specifically
1
271 (49.69%) patients were considered as qi-deficient constitution
and 1
227 (47.97%) patients were determined as stagnant blood constitution. There were 1
303 (50.94%) patients diagnosed as blood stasis syndrome
1
280 (50.04%) patients exhibited phlegm and dampness syndrome and 1
012 (39.56%) patients demonstrated qi deficiency syndrome. And 1
033 (40.38%) patients declared intracranial artery stenosis
and 478 (18.69%) patients reported carotid artery stenosis. The plaque in 1
508 (41.36%) patients were of mixed. Particularly
41.09% of them demonstrated abnormal levels of glycated hemoglobin (HbA1c) levels.
Conclusions:
2
Recurrence in minor and small-artery stroke cannot be ignored. Hypertension
dyslipidemia
abnormal HbA1c
intracranial artery stenosis and carotid plaque were more common in stroke patients. Particularly
phlegm-dampness and blood stasis syndromes
as well as qi deficiency and blood stasis constitutions
were still the main manifestations of stroke. (Trial registration at ClinicalTrials.gov
No. NCT03174535)
noncardiogenic ischemic strokeChinese medicine hospitalonset characteristicsrecurrence
Marsh JD, Keyrouz SG. Stroke prevention and treatment. J Am Coll Cardiol 2010;56:683-691.
Wu XM, Zhu B, Fu LY, Wang HL, Zhou B, Zou SF, et al. Correction:prevalence, incidence, and mortality of stroke in the Chinese island populations: a systematic review. PLoS One 2013;8:e78629.
Johnston SC, Mendis S, Mathers CD. Global variation in stroke burden and mortality: estimates from monitoring, surveillance,and modelling. Lancet Neurol 2009;8:345-354.
GBD 2016 Stroke Collaborators. Global, regional, and national burden of stroke,1990–2016: a system atic analysis for the Global Burden of Disease Study 2016. Lancet Neurol 2019;18:439-458.
Wang LD. Brief report on stroke prevention and treatment in China 2019. Chin J Cerebrovascular Dis (Chin) 2020;17:272-281.
WHO. The top 10 causes of death [EB/OL] [Accessed 2019-3-10].Available at: http://www.who.int/mediacentre/factsheets/fs310/en/http://www.who.int/mediacentre/factsheets/fs310/en/.
Zhou MG, Wang HD, Zeng XY, Yin P, Zhu J, Chen WQ,et al. Mortality, morbidity, and risk factors in China and its provinces,1990–2017: a system aticanalysis for the Global Burden of Disease Study 2017. Lancet 2019;394:1145-1158.
Wu LY, Wang AX, Wang XW, Zhao XQ, Wang CX, Liu LP,et al. Factors for short-term outcomes in patients with a minor stroke: results from China National Stroke Registry. BMC Neurol 2015;15:253.
Pan Y, Wang Y, Li H, Gaisano HY, Wang YL, He Y. Association of diabetes and prognosis of minor stroke and its subtypes: a prospective observational study. PLoS One 2016;11:e0153178.
Zhao L, Wang RH, Song B, Tan S, Gao Y, Fang H, et al.Association between atherogenic dyslipidemia and recurrent stroke risk in patients with different subtypes of ischemic stroke.Int J Stroke 2015;10:752-758.
Chinese Society of Neurology. Acute Ischemic stroke diagnosis and treatment guidelines of China 2014. Chin J Neurol (Chin)2015;48:246-257.
Fure B, Wyller TB,Thommessen B . TOAST criteria applied in acute ischemic stroke. Acta Neurologica Scandinavica 2010;112:254-258.
Wilson JT, Hareendran A, Grant M, Baird T, Schulz UGR, Muir KW, et al. Improving the assessment of outcomes in stroke: use of a structured interview to assign grades on the modified Rankin Scale. Stroke 2002;33:2243.
Hou DZ, Zhang Y, Wu LJ, LI Y, An ZP. The reliability and validity of the Chinese version of the National Institutes of Health Stroke Scale. Chin J Phys Med Rehabil (Chin) 2012;34:3.
Wang RZ, Liu LF, Cui KY, Ge HM. Study on the feasibility of the Self-rating Depression Scale as a routine screened implement for depressive disorder of internal medicine inpatients. Chin J Health Psychol (Chin) 2009;17:923-925.
Leung DY, Wong EM, Chan AW, Zhao Y, Sit JW. Associations between body-mass index and second-hand smoke exposure and stroke recurrence in Chinese patients in Xi'an, Shantou,and Chongqing: a multicenter cross-sectional survey. Lancet 2016;388:S50-S50-(1).
Zhang FL, Guo ZN, Wu YH, Liu HY, Luo Y, Sun MS, et al.Prevalence of stroke and associated risk factors: a population based cross sectional study from northeast China. BMJ Open 2017;7:e015758.
American Diabetes Association. Diagnosis and classification of diabetes mellitus. Diabetes Care 2013;36:S67-S74.
Zhu JR, Gao RL, Zhao SP, Lu GP, Zhao D, Li JJ. Chinese guidelines on prevention and treatment of dyslipidemia in adults(revised in 2016). Chin Circul J (Chin) 2016,31:937-953.
Jing HR. The development of the English version of the constitution in Chinese medicine questionnaire (CMMQ) and the investigation of the CCM epidemiology in the American and Canadian [Dissertation]. Beijing: Beijing University of Chinese Medicine; 2012.
Gao Y, Ma B, Liu Q. Methodological study and establishment of the diagnostic scale for traditional Chinese medicine syndromes of ischemic stroke. J Tradit Chin Med (Chin) 2011;52:2097-2101.
Chang KC, Chuang IC, Huang YC, Wu CY, Lin WC, Kuo YL,et al. Risk factors outperform intracranial large artery stenosis predicting unfavorable outcomes in patients with stroke. BMC Neurol 2019;19:180.
Grant EG, Benson CB, Moneta GL, Alexandrov AV, Baker JD,Bluth EI, et al. Carotid artery stenosis:gray-scale and Doppler ultrasound diagnosis—Society of Radiologists in Ultrasound Consensus Conference. Ultrasound Q 2003;19:190.
Polak JF, Shemanski L, O'Leary DH, Lefkowitz D, Price TR,Savage PJ, et al. Hypoechoic plaque at US of the carotid artery: an independent risk factor for incident stroke in adults aged 65 years or older. Cardiovascular Health Study. Radiology 1998;208:649.
Wang Z, Li JJ, Wang CX, Yao XM, Zhao XQ, Wang Yl, et al. Gender differences in 1-year clinical characteristics and outcomes after stroke: results from the China National Stroke Registry. PLoS One 2013;8:e56459.
Wang YJ, Wang YL, Zhao XQ. Clopidogrel with aspirin in acute minor stroke or transient ischemic attack. N Engl J Med 2013;369:11-19.
Zhang Y, Liu Y, Wang GQ, Sun SL, Gao Y, Xie YM. Risk assessment model for endpoints of ischemic stroke: a study protocol for a registry study. J Tradit Chin Med 2018,38:936-942.
Zhao D, Liu J, Wang W, Zeng ZC, Cheng J, Liu J, et al.Epidemiological transition of stroke in China: twenty-one-year observational study from the Sino-MONICA-Beijing Project.Stroke 2008;39:1668-1674.
Li JX, Xu XJ. Research progress on hypertension, carotid atherosclerosis and stroke. Chin Heart J (Chin) 2007;19:354-356.
Wang CS. A probe into the physical characteristics of Chinese contemporary old people. Jiangsu J Tradit Chin Med (Chin)2004;25:16-19.
O'Donnell MJ, Xavier D, Liu L, Agrawal A. Risk factors for ischemic and intracerebral haemorrhagic stroke in 22 countries(the INTER STROKE study): a case-control study. Lancet 2010,376:112-123.
Dai YY, Yan MG, Dai QD, Zhang JP, Lu WG, Jiang B, et al.Correlation between different plasma fibrinogen levels and cerebral infarction. Neural Injury Funct Reconstruct 2016;402-403.
Sun CM, Wu PR. Correlation analysis of early fasting blood glucose level and clinical prognosis in patients with acute cerebral infarction. Chin J Pract Nervous Dis (Chin) 2016;19:113-114.
Zhang MY, Lyu XF, Zhang WW, Wang GQ, Zhang XG,Luo P. The effect and significance of blood glucose fluctuation on vascular endothelial injury in patients with type 2 diabetes and acute cerebral infarction. Chin J Gerontol (Chin) 2016;36:329-331.
He P. The changes of blood lipid, apolipoprotein and blood uric acid levels in patients with cerebral infarction. Chin J Laborat Diagn (Chin) 2019;23:1038-1040.
Madsen JS, Kristensen SR, Klitgaard NA, Bladbjerg EM, Bo A,Stilgren L, et al. Effect of long-term hormone replacement therapy on plasma homocysteine in postmenopausal women: a randomized controlled study. Am J Obstet Gynecol 2002;187:33-39.
Hua Y, Jia LY, Xing YQ, Hui P, Meng X, Yu D, et al. Distribution pattern of atherosclerotic stenosis in Chinese patients with stroke: a multicenter registry study. Aging Dis 2019;10:62-70.
Wang YJ, Zhao XQ, Liu LP, Soo YO, Pu Y, Pan Y, et al.Prevalence and outcomes of symptomatic intracranial large artery stenoses and occlusions in China: the Chinese Intracranial Atherosclerosis (CICAS) study. Stroke 2014;45:663-669.
Gorelick PB, Wong KS, Bae HJ, Pandey DK. Large artery intracranial occlusive disease: a large worldwide burden but a relatively neglected frontier. Stroke 2008;39:2396-2399.
Shen L, Zhou HC, Wei F, Wang HX, Wang G, Shuai J. Clinical study on the relationship between middle cerebral artery stenosis, basal ganglia hemorrhage and cerebral infarction. J Region Anatomy Operation Surg (Chin) 2019; 28:964-969.
Shi YH. The clinical value of cervical vascular ultrasound in patients with ischemic cerebrovascular disease. J Imag Res Med Appl (Chin) 2019;3:68-69.
Rundek T, Gardener H, Della-Morte D, Dong C, Cabral D,Tiozzo E, et al. The relationship between carotid intima-media thickness and carotid plaque in the Northern Manhattan Study.Atherosclerosis 2015;241:364-370.
Li JQ. Analysis of clinical effect of carotid ultrasound in the diagnosis of patients with arteriosclerotic cerebral infarction. J Frontiers Med (Chin) 2017;7:147-148.
Yang XD. The value of carotid ultrasound in the diagnosis of arteriosclerotic cerebral infarction. Guid China Med (Chin)2018;16:73.
Zhou CY, Han GX, Yang YF. The prediction value of carotid plaque ultrasound image risk classification in predicting ischemic stroke relapse. Hebei Med J (Chin) 2018;40:92-95.
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