醒后卒中临床诊治的研究新进展

doi:10.12114/j.issn.1007-9572.2022.0349

中国全科医学 ›› 2022, Vol. 25 ›› Issue (29): 3607-3615.DOI: 10.12114/j.issn.1007-9572.2022.0349

• 临床热点关注·脑健康研究 • 上一篇下一篇

醒后卒中临床诊治的研究新进展

刘筱翼¹^,², 王保爱³^,^*()

1．030000　山西省太原市，山西医科大学
2．032200　山西省汾阳市，山西医科大学汾阳学院
3．032200　山西省汾阳市，山西医科大学附属汾阳医院　山西省汾阳医院神经内科

收稿日期:2022-03-13 修回日期:2022-05-20 出版日期:2022-10-15 发布日期:2022-07-07
通讯作者: 王保爱
刘筱翼，王保爱.醒后卒中临床诊治的研究新进展[J].中国全科医学，2022，25（29）：3607-3615. [www.chinagp.net]
作者贡献：刘筱翼、王保爱负责文章框架的构思与设计；刘筱翼负责文章资料的收集与整理、文章的撰写与修改；王保爱负责文章的修改、质量把控、最终版本的修订及审核。
基金资助:
山西省医学重点科研项目(2021XM41)

Progress in Clinical Diagnosis and Treatment of Wake-up Stroke

Xiaoyi LIU¹^,², Baoai WANG³^,^*()

1. Shanxi Medical University, Taiyuan 030000, China
2. Fenyang College of Shanxi Medical University, Fenyang 032200, China
3. Department of Neurology, the Fenyang Hospital of Shanxi Medical University/Shanxi Fenyang Hospital, Fenyang 032200, China

Received:2022-03-13 Revised:2022-05-20 Published:2022-10-15 Online:2022-07-07
Contact: Baoai WANG
About author:
LIU X Y, WANG B A. Progress in clinical diagnosis and treatment of wake-up stroke[J]. Chinese General Practice, 2022, 25 (29) : 3607-3615.

分享到

摘要/Abstract

摘要： 醒后卒中（WUS）是指睡前无新发卒中症状，在醒后或睡眠过程中出现新发神经系统功能缺损的急性脑血管病，症状开始时间未知，多属缺血性卒中。近年来，随着对WUS发病机制的探究以及电子计算机断层扫描和磁共振成像等影像学技术的应用和发展，临床可以对缺血半暗带及脑灌注进行探索，判断是否存在可挽救的脑组织，制定合适的治疗方案，已成为临床研究热点。本文就WUS的临床诊断及治疗等方面进行综述。

关键词: 醒后卒中, 缺血性卒中, 血压, 睡眠呼吸暂停综合征, 静脉溶栓, 机械取栓

Abstract:

Wake-up stroke (WUS) refers to acute cerebrovascular disease without new onset stroke symptoms at bedtime whereas new onset neurological deficits after waking up or during sleep. With unknown onset time of symptoms, most cases are ischemic stroke. Recently, with the exploration of the pathogenesis of WUS and the application and development of imaging techniques such as electron computed tomography and magnetic resonance imaging, it is possible to explore the ischemic penumbra and cerebral perfusion, judge the presence of salvageable brain tissue, and develop a suitable treatment plan, which has become a hot spot in clinical research. This review focuses on the clinical diagnosis and treatment of stroke after waking up.

Key words: Wake-up stroke, Ischemic stroke, Blood pressure, Sleep apnea syndromes, Hrombolytic therapy, Mechanical thrombectomy

刘筱翼,王保爱. 醒后卒中临床诊治的研究新进展[J]. 中国全科医学, 2022, 25(29): 3607-3615. DOI: 10.12114/j.issn.1007-9572.2022.0349.
Xiaoyi LIU,Baoai WANG. Progress in Clinical Diagnosis and Treatment of Wake-up Stroke[J]. Chinese General Practice, 2022, 25(29): 3607-3615. DOI: 10.12114/j.issn.1007-9572.2022.0349.

参考文献 75

[1]	WANG W Z, JIANG B, SUN H X，et al. Prevalence，incidence，and mortality of stroke in China：results from a nationwide population-based survey of 480 687 adults[J]. Circulation，2017，135(8):759-771. DOI：10.1161/CIRCULATIONAHA.116.025250.
[2]	REID J M, DAI D W, CHERIPELLI B，et al. Differences in wake-up and unknown onset stroke examined in a stroke registry[J]. Int J Stroke，2015，10(3):331-335. DOI：10.1111/ijs.12388.
[3]	TSAI J P, ALBERS G W. Wake-up stroke：current understanding[J]. Top Magn Reson Imaging，2017，26(3):97-102. DOI：10.1097/RMR.0000000000000126.
[4]	POWERS W J, RABINSTEIN A A, ACKERSON T，et al. Guidelines for the early management of patients with acute ischemic stroke：2019 update to the 2018 guidelines for the early management of acute ischemic stroke：a guideline for healthcare professionals from the American Heart Association/American Stroke Association[J]. Stroke，2019，50(12):e344-418. DOI：10.1161/STR.0000000000000211.
[5]	中华医学会神经病学分会，中华医学会神经病学分会脑血管病学组. 中国急性缺血性脑卒中诊治指南2018[J]. 中华神经科杂志，2018，51(9):666-682. DOI：10.3760/cma.j.issn.1006-7876.2018.09.004.
[6]	CAMPBELL B C V, MA H, RINGLEB P A，et al. Extending thrombolysis to 4.5-9 h and wake-up stroke using perfusion imaging：a systematic review and meta-analysis of individual patient data[J]. Lancet，2019，394(10193):139-147. DOI：10.1016/S0140-6736(19)31053-0.
[7]	DINIZ D L, BARRETO P R, BRUIN P F，et al. Wake-up stroke：clinical characteristics，sedentary lifestyle，and daytime sleepiness[J]. Rev Assoc Med Bras （1992），2016，62(7):628-634. DOI：10.1590/1806-9282.62.07.628.
[8]	GUO C P, BAI Q K, ZHAO Z G，et al. Recombinant tissue-type plasminogen activator study of wake-up ischemic strokes guided by rapid MRI[J]. Cerebrovasc Dis，2019，48(1/2):85-90. DOI：10.1159/000503379.
[9]	张文玉，邹宁，李琦，等. 醒后卒中的临床特点及早期预后研究[J]. 中国脑血管病杂志，2018，15(10):516-522. DOI：10.3969/j.issn.1672-5921.2018.10.003.
[10]	郭群，李璐，吴含，等. 探讨改良DWI-FLAIR不匹配指导醒后缺血性卒中静脉溶栓治疗疗效[J]. 磁共振成像，2020，11(10):853-857. DOI：10.12015/issn.1674-8034.2020.10.004.
[11]	JOVIN T G. MRI-guided intravenous alteplase for stroke - still stuck in time[J]. N Engl J Med，2018，379(7):682-683. DOI：10.1056/NEJMe1805796.
[12]	王凯，魏秀娥，荣良群，等. 醒后卒中的发病机制及预后不良的影响因素研究[J]. 中华神经科杂志，2019，52(4):273-280. DOI：10.3760/cma.j.issn.1006-7876.2019.04.005.
[13]	FU X, LI J, WU J J，et al. Reduced cortical arousability to nocturnal apneic episodes in patients with wake-up ischemic stroke[J]. Sleep Med，2020，66:252-258. DOI：10.1016/j.sleep.2019.09.007.
[14]	THOMALLA G, BOUTITIE F, FIEBACH J B，et al. Stroke with unknown time of symptom onset：baseline clinical and magnetic resonance imaging data of the first thousand patients in WAKE-UP （efficacy and safety of MRI-based thrombolysis in wake-up stroke：a randomized，doubleblind，placebo-controlled trial）[J]. Stroke，2017，48(3):770-773. DOI：10.1161/STROKEAHA.116.015233.
[15]	LUNDHOLM M D, ROONEY M, MAAS M B，et al. Wake-up stroke is associated with greater nocturnal mean arterial pressure variability[J]. Stroke，2017，48(6):1668-1670. DOI：10.1161/STROKEAHA.116.016202.
[16]	ELLIOTT W J. Circadian variation in the timing of stroke onset：a meta-analysis[J]. Stroke，1998，29(5):992-996. DOI：10.1161/01.str.29.5.992.
[17]	YULUG B, HANOGLU L, KILIC E. Commentary：toward a personalized medicine in wake-up stroke? [J]. CNS Neurol Disord Drug Targets，2017，16(10):1049. DOI：10.2174/1871527316666170727124327.
[18]	嵇朋，寇启星，孟凡超，等. 觉醒型急性缺血性脑卒中与睡眠呼吸暂停综合征的研究[J]. 中华老年心脑血管病杂志，2021，23(11):1192-1194. DOI：10.3969/j.issn.1009-0126.2021.11.019.
[19]	WOO H G, SONG T J, JUNG J S，et al. Association between the high risk for obstructive sleep apnea and intracranial carotid artery calcification in patients with acute ischemic stroke[J]. Schlaf Atmung，2021，25(1):299-307. DOI：10.1007/s11325-020-02117-x.
[20]	KOO B B, BRAVATA D M, TOBIAS L A，et al. Observational study of obstructive sleep apnea in wake-up stroke：the SLEEP TIGHT study[J]. Cerebrovasc Dis，2016，41(5/6):233-241. DOI：10.1159/000440736.
[21]	OZDEMIR O, BELETSKY V, HACHINSKI V，et al. Cerebrovascular events on awakening，patent foramen ovale and obstructive sleep apnea syndrome[J]. J Neurol Sci，2008，268(1/2):193-194. DOI：10.1016/j.jns.2007.11.010.
[22]	付强，郭彩霞. 卵圆孔未闭与阻塞性睡眠呼吸暂停关系的研究进展[J]. 中国医药，2019，14(4):621-624. DOI：10.3760/j.issn.1673-4777.2019.04.035.
[23]	MAN H H, XU Y T, ZHAO Z M，et al. The coexistence of a patent foramen ovale and obstructive sleep apnea may increase the risk of wake-up stroke in young adults[J]. Technol Health Care，2019，27(S1):23-30. DOI：10.3233/THC-199004.
[24]	COSTA R, PINHO J, ALVES J N，et al. Wake-up stroke and stroke within the therapeutic window for thrombolysis have similar clinical severity，imaging characteristics，and outcome[J]. J Stroke Cerebrovasc Dis，2016，25(3):511-514. DOI：10.1016/j.jstrokecerebrovasdis.2015.10.032.
[25]	CORINO V D, PLATONOV P G, ENGER S，et al. Circadian variation of variability and irregularity of heart rate in patients with permanent atrial fibrillation：relation to symptoms and rate control drugs[J]. Am J Physiol Heart Circ Physiol，2015，309(12):H2152-2157. DOI：10.1152/ajpheart.00300.2015.
[26]	POLI M, PHILIP P, TAILLARD J，et al. Atrial fibrillation is a major cause of stroke in apneic patients：a prospective study[J]. Sleep Med，2017，30:251-254. DOI：10.1016/j.sleep.2015.07.031.
[27]	刘丽丽，李国忠，钟镝，等. 糖化血红蛋白在缺血性卒中应用研究进展[J]. 中国卒中杂志，2016，11(12):1067-1071. DOI：10.3969/j.issn.1673-5765.2016.12.014.
[28]	段春苗，陈书阁，石富铭. 血糖及糖化血红蛋白与急性缺血性卒中亚型的相关性[J]. 临床医学研究与实践，2018，3(15):20-21. DOI：10.19347/j.cnki.2096-1413.201815008.
[29]	JADHAV A P, DESAI S M, HIRSCH J A. Thrombolysis in patients with WAKE-UP or unknown time of stroke onset：ready for prime time? [J]. J Neurointerv Surg，2018，10(12):1130-1131. DOI：10.1136/neurintsurg-2018-014154.
[30]	NAGAI K, AOKI J, SAKAMOTO Y，et al. About 30% of wake-up stroke patients may be candidate for the tPA therapy using Negative-FLAIR as a "tissue clock" [J]. J Neurol Sci，2017，382:101-104. DOI：10.1016/j.jns.2017.09.042.
[31]	黄红涛，靳明旭，彭明洋，等. FLAIR血管高信号在评估未再灌注治疗的卒中预后中的价值[J]. 磁共振成像，2020，11(1):6-10. DOI：10.12015/issn.1674-8034.2020.01.002.
[32]	BHASKAR S, STANWELL P, CORDATO D，et al. Reperfusion therapy in acute ischemic stroke：dawn of a new era? [J]. BMC Neurol，2018，18(1):8. DOI：10.1186/s12883-017-1007-y.
[33]	SCHELDEMAN L, WOUTERS A, BOUTITIE F，et al. Different mismatch concepts for magnetic resonance imaging-guided thrombolysis in unknown onset stroke[J]. Ann Neurol，2020，87(6):931-938. DOI：10.1002/ana.25730.
[34]	DANKBAAR J W, BIENFAIT H P, VAN DEN BERG C，et al. Wake-up stroke versus stroke with known onset time：clinical and multimodality CT imaging characteristics[J]. Cerebrovasc Dis，2018，45(5/6):236-244. DOI：10.1159/000489566.
[35]	CARUSO P, NACCARATO M, FURLANIS G，et al. Wake-up stroke and CT perfusion：effectiveness and safety of reperfusion therapy[J]. Neurol Sci，2018，39(10):1705-1712. DOI：10.1007/s10072-018-3486-z.
[36]	ONDER H, GUNCU O, HASGUL B，et al. The reliability of the evaluation of diffusion-weighted imaging in suspected stroke by emergency physicians[J]. J Neurosci Rural Pract，2020，11(1):151-155. DOI：10.1055/s-0039-3402589.
[37]	LEGGE J, GRAHAM A, MALE S，et al. Fluid-attenuated inversion recovery （FLAIR） signal intensity can identify stroke within 6 and 8 hours[J]. J Stroke Cerebrovasc Dis，2017，26(7):1582-1587. DOI：10.1016/j.jstrokecerebrovasdis.2017.02.030.
[38]	JAKUBICEK S, KREBS S, POSEKANY A，et al. Modified DWI-FLAIR mismatch guided thrombolysis in unknown onset stroke[J]. J Thromb Thrombolysis，2019，47(2):167-173. DOI：10.1007/s11239-018-1766-3.
[39]	THOMALLA G, SIMONSEN C Z, BOUTITIE F，et al. MRI-guided thrombolysis for stroke with unknown time of onset[J]. N Engl J Med，2018，379(7):611-622. DOI：10.1056/NEJMoa1804355.
[40]	NOGUEIRA R, LIEBESKIND D, GUPTA R，et al. 030 Preliminary data for the dawn trial （DWI/PWI and CTP assessment in the triage of wake-up and late presenting strokes undergoing neurointervention）：imaging based endovascular therapy for proximal anterior circulation occlusions beyond 8 h from last seen well in 193 stroke patients[J]. J Neurointerventional Surg，2009，1(1):85. DOI：10.1136/jnis.2009.001016d.
[41]	吕娟，赵红梅，赵杰，等. PWI指导最后正常时间>4.5h醒后脑卒中静脉溶栓临床观察[J]. 中国实用神经疾病杂志，2018，21(22):2456-2462. DOI：10.12083/SYSJ.2018.22.523.
[42]	ZAHARCHUK G. Better late than never：the long journey for noncontrast arterial spin labeling perfusion imaging in acute stroke[J]. Stroke，2012，43(4):931-932. DOI：10.1161/STROKEAHA.111.644344.
[43]	WANG D M, HAO P, WANG M Y，et al. Mismatch of ASPECTS based on arterial spin labeling and diffusion-weighted imaging as an indicator for mechanical thrombectomy in patients with wake-up stroke[J]. J South Med Univ，2020，40(1):1-5. DOI：10.12122/j.issn.1673-4254.2020.01.01.
[44]	廖晓凌，王伊龙，王拥军，等. 临床核磁弥散成像不匹配对预测缺血半暗带的价值[J]. 中华老年心脑血管病杂志，2007，9(4):247-249. DOI：10.3969/j.issn.1009-0126.2007.04.014.
[45]	NOGUEIRA R G, KEMMLING A, SOUZA L M，et al. Clinical diffusion mismatch better discriminates infarct growth than mean transit time-diffusion weighted imaging mismatch in patients with middle cerebral artery-M1 occlusion and limited infarct core[J]. J Neurointerv Surg，2017，9(2):127-130. DOI：10.1136/neurintsurg-2014-011602.
[46]	朱云波，李佳佳，高燕军，等. 大鼠急性脑梗死后超时间窗溶栓治疗对脑损伤的影响[J]. 中国老年学杂志，2018，38(2):281-284. DOI：10.3969/j.issn.1005-9202.2018.02.010.
[47]	SCHUHMANN M K, KRSTIC M, KLEINSCHNITZ C，et al. Fingolimod （FTY720） reduces cortical infarction and neurological deficits during ischemic stroke through potential maintenance of microvascular patency[J]. Curr Neurovasc Res，2016，13(4):277-282. DOI：10.2174/1567202613666160823152446.
[48]	MIAO L Y, YANG J, HUANG C R，et al. Contribution of age，body weight，and CYP2C9 and VKORC1 genotype to the anticoagulant response to warfarin：proposal for a new dosing regimen in Chinese patients[J]. Eur J Clin Pharmacol，2007，63(12):1135-1141. DOI：10.1007/s00228-007-0381-6.
[49]	CHAO A C, HSU H Y, CHUNG C P，et al. Outcomes of thrombolytic therapy for acute ischemic stroke in Chinese patients：the Taiwan Thrombolytic Therapy for Acute Ischemic Stroke（TTT-AIS） study[J]. Stroke，2010，41(5):885-890. DOI：10.1161/STROKEAHA.109.575605.
[50]	KOGA M, TOYODA K, KIMURA K，et al. THrombolysis for acute wake-up and unclear-onset strokes with alteplase at 0.6 mg/kg （THAWS） trial[J]. Int J Stroke，2014，9(8):1117-1124. DOI：10.1111/ijs.12360.
[51]	ŠKRBIC R, VUJKOVIC Z, STOJILJKOVIC M P，et al. Efficacy and safety of low-dose versus standard-dose alteplase regimens in patients with acute ischaemic stroke[J]. Psychiatr Danub，2019，31(Suppl 1):32-38.
[52]	Tissue plasminogen activator for acute ischemic stroke. The National Institute of Neurological Disorders and Stroke t-PA Stroke Study Group[J]. J Neurosurg Anesthesiol，1996，8(2):172. DOI：10.1097/00008506-199604000-00018.
[53]	HACKE W, KASTE M, BLUHMKI E，et al. Thrombolysis with alteplase 3 to 4.5 hours after acute ischemic stroke[J]. N Engl J Med，2008，359(13):1317-1329. DOI：10.1056/NEJMoa0804656.
[54]	DAVIS S M, DONNAN G A, PARSONS M W，et al. Effects of alteplase beyond 3 h after stroke in the Echoplanar Imaging Thrombolytic Evaluation Trial （EPITHET）：a placebo-controlled randomised trial[J]. Lancet Neurol，2008，7(4):299-309. DOI：10.1016/S1474-4422(08)70044-9.
[55]	MA H, CAMPBELL B C V, PARSONS M W，et al. Thrombolysis guided by perfusion imaging up to 9 hours after onset of stroke[J]. N Engl J Med，2019，380(19):1795-1803. DOI：10.1056/NEJMoa1813046.
[56]	RINGLEB P, BENDSZUS M, BLUHMKI E，et al. Extending the time window for intravenous thrombolysis in acute ischemic stroke using magnetic resonance imaging-based patient selection[J]. Int J Stroke，2019，14(5):483-490. DOI：10.1177/1747493019840938.
[57]	THOMALLA G, BOUTITIE F, MA H，et al. Intravenous alteplase for stroke with unknown time of onset guided by advanced imaging：systematic review and meta-analysis of individual patient data[J]. Lancet，2020，396(10262):1574-1584. DOI：10.1016/S0140-6736(20)32163-2.
[58]	BERGE E, WHITELEY W, AUDEBERT H，et al. European Stroke Organisation （ESO） guidelines on intravenous thrombolysis for acute ischaemic stroke[J]. Eur Stroke J，2021，6(1):I-LXII. DOI：10.1177/2396987321989865.
[59]	高峰，符莹莹，魏晓娜，等. 瑞替普酶静脉溶栓治疗急性脑梗死130例疗效观察[J]. 中国实用内科杂志，2017，37(11):1011-1012. DOI：10.19538/j.nk2017110123.
[60]	BIVARD A, HUANG X Y, LEVI C R，et al. Tenecteplase in ischemic stroke offers improved recanalization：analysis of 2 trials[J]. Neurology，2017，89(1):62-67. DOI：10.1212/WNL.0000000000004062.
[61]	CAMPBELL B C V, MITCHELL P J, CHURILOV L，et al. Tenecteplase versus alteplase before thrombectomy for ischemic stroke[J]. N Engl J Med，2018，378(17):1573-1582. DOI：10.1056/NEJMoa1716405.
[62]	WARACH S J, DULA A N, MILLING T J Jr. Tenecteplase thrombolysis for acute ischemic stroke[J]. Stroke，2020，51(11):3440-3451. DOI：10.1161/STROKEAHA.120.029749.
[63]	OLIVEIRA M, FIDALGO M, FONTÃO L，et al. Tenecteplase for thrombolysis in stroke patients：systematic review with meta-analysis[J]. Am J Emerg Med，2021，42:31-37. DOI：10.1016/j.ajem.2020.12.026.
[64]	KATSANOS A H, SAFOURIS A, SARRAJ A，et al. Intravenous thrombolysis with tenecteplase in patients with large vessel occlusions：systematic review and meta-analysis[J]. Stroke，2021，52(1):308-312. DOI：10.1161/STROKEAHA.120.030220.
[65]	KATE M, WANNAMAKER R, KAMBLE H，et al. Penumbral imaging-based thrombolysis with tenecteplase is feasible up to 24 hours after symptom onset[J]. J Stroke，2018，20(3):415. DOI：10.5853/jos.2017.00178.e1.
[66]	AHMED H K, LOGALLO N, THOMASSEN L，et al. Clinical outcomes and safety profile of tenecteplase in wake-up stroke[J]. Acta Neurol Scand，2020，142(5):475-479. DOI：10.1111/ane.13296.
[67]	NOGUEIRA R G, JADHAV A P, HAUSSEN D C，et al. Thrombectomy 6 to 24 hours after stroke with a mismatch between deficit and infarct[J]. N Engl J Med，2018，378(1):11-21. DOI：10.1056/NEJMoa1706442.
[68]	ALBERS G W, MARKS M P, KEMP S，et al. Thrombectomy for stroke at 6 to 16 hours with selection by perfusion imaging[J]. N Engl J Med，2018，378(8):708-718. DOI：10.1056/NEJMoa1713973.
[69]	ATCHANEEYASAKUL K, MALIK A M, YAVAGAL D R，et al. Thrombectomy outcomes in acute ischemic stroke due to middle cerebral artery m2 occlusion with stent retriever versus aspiration：a multicenter experience[J]. Interv Neurol，2020，8(2/3/4/5/6):180-186. DOI：10.1159/000500198.
[70]	LI G S, HUANG R, LI W S，et al. Mechanical thrombectomy with second-generation devices for acute cerebral middle artery M2 segment occlusion：a meta-analysis[J]. Interv Neuroradiol，2020，26(2):187-194. DOI：10.1177/1591019919886405.
[71]	中华医学会神经病学分会，中华医学会神经病学分会脑血管病学组，中华医学会神经病学分会神经血管介入协作组. 中国急性缺血性脑卒中早期血管内介入诊疗指南2018[J]. 中华神经科杂志，2018，51(9):683-691. DOI：10.3760/cma.j.issn.1006-7876.2018.09.005.
[72]	张萍，张敏敏，杨鹏飞，等. RAPID软件在急性缺血性脑卒中血管内治疗患者预后预测中的应用价值[J]. 第二军医大学学报，2018，39(9):1013-1018. DOI：10.16781/j.0258-879x.2018.09.1013.
[73]	BATHLA G, LIMAYE K, POLICENI B，et al. Achieving comparable perfusion results across vendors. The next step in standardizing stroke care：a technical report[J]. J Neurointerv Surg，2019，11(12):1257-1260. DOI：10.1136/neurintsurg-2019-014810.
[74]	XIONG Y Y, HUANG C C, FISHER M，et al. Comparison of automated CT perfusion softwares in evaluation of acute ischemic stroke[J]. J Stroke Cerebrovasc Dis，2019，28(12):104392. DOI：10.1016/j.jstrokecerebrovasdis.2019.104392.
[75]	CAI H, FAN S Y, BIAN Y Y，et al. Two-way comparison of brain perfusion image processing software for patients with acute ischemic strokes in real-world[J]. Neuroradiology，2022，64(1):161-169. DOI：10.1007/s00234-021-02771-2.

醒后卒中临床诊治的研究新进展

Progress in Clinical Diagnosis and Treatment of Wake-up Stroke

RichHTML

PDF

可视化

摘要/Abstract

引用本文

使用本文

参考文献 75

相关文章 15

编辑推荐

Metrics

留言

[1]	张帅, 李琴, 李东锋, 肖金平, 李云鹏. 使用固体燃料与中国老年人高血压发病风险的前瞻性队列研究[J]. 中国全科医学, 2023, 26(32): 4001-4006.
[2]	胡佳玉, 任丽珏, 靳欢欢, 孙婷婷, 靳美娜, 周雪利, 魏翠英. 阻塞性睡眠呼吸暂停综合征患者脂肪因子Metrnl水平及其与炎症和胰岛素抵抗的关系研究[J]. 中国全科医学, 2023, 26(30): 3748-3752.
[3]	肖礼其, 杨莉, 崔赛仙, 张娅袁, 王玉路, 何燕. 高盐诱导肠道菌群紊乱调节盐敏感性血压的机制研究[J]. 中国全科医学, 2023, 26(29): 3704-3709.
[4]	张云盛, 张鹏, 靳育静, 高鹰. 中国长寿地区老年人血压水平与慢性肾脏病发病风险的关联研究[J]. 中国全科医学, 2023, 26(28): 3502-3506.
[5]	程晓冉, 张笑天, 李明月, 程昊哲, 汤皓晴, 郑汇娴, 张柏松, 刘晓云. 医防融合背景下慢性病随访对高血压和糖尿病患者健康行为及血压/血糖控制的影响研究[J]. 中国全科医学, 2023, 26(28): 3482-3488.
[6]	边立立, 李肖肖, 杜雪平, 戴勤芳, 武琳, 宋贝贝. 社区建档高血压患者动脉粥样硬化性心血管疾病危险分层及血脂达标调查研究[J]. 中国全科医学, 2023, 26(27): 3388-3391.
[7]	刘月, 刘琦, 董惠, 刘亚玲. 基于蒙特利尔认知评定量表双阈值定义的卒中后认知"恢复者"神经心理学变化研究[J]. 中国全科医学, 2023, 26(27): 3417-3422.
[8]	王晓雯, 肖统领, 王祎, 杨莹, 夏晓爽, 李新. 急性缺血性脑卒中患者同型半胱氨酸水平与急性肾损伤的关系研究[J]. 中国全科医学, 2023, 26(26): 3290-3296.
[9]	赵伟, 唐荣杰, 杨珊珊, 杨芳, 孙锋, 廉秋芳. Klotho在盐敏感性高血压肾损伤中的作用及分子机制研究[J]. 中国全科医学, 2023, 26(24): 3042-3049.
[10]	张勇, 蔡翔, 宁菲菲, 梁潇, 郭宁. 沙库巴曲缬沙坦与达格列净治疗血压偏低的扩张型心肌病疗效及安全性比较研究[J]. 中国全科医学, 2023, 26(23): 2912-2917.
[11]	左旭, 黄招兰, 陆彪. 35~64岁自报非高血压人群首次血压测量与非同日3次血压测量结果的差异及其影响因素分析[J]. 中国全科医学, 2023, 26(22): 2771-2777.
[12]	冯佳, 王洁, 余丹, 刘永恒, 赵伟栋, 田宏远. 2010—2021年国内外老年多重慢病研究热点分析[J]. 中国全科医学, 2023, 26(21): 2574-2580.
[13]	费敏, 雷思, 许琰, 叶云, 卓慧, 张慧, 罗荧荃. 阻塞性睡眠呼吸暂停低通气综合征对高血压患者血压变异性和心率变异性的影响研究[J]. 中国全科医学, 2023, 26(20): 2459-2468.
[14]	禹彤, 杨一, 杜诗虹, 丁梓豪, 洪秀琴. 剪切力和雌二醇与高血压的相关性研究[J]. 中国全科医学, 2023, 26(20): 2469-2475,2495.
[15]	田梅香, 张正义. 备孕期高血压的规范管理[J]. 中国全科医学, 2023, 26(18): 2190-2194.