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| 急性缺血性脑卒中超早期静脉溶栓治疗中假卒中的临床特点及鉴别 |
| 陈蕾,朱宣,张萍,张敏敏,姜一,邢鹏飞,张永巍,吴涛,邓本强* |
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(第二军医大学长海医院脑血管病中心, 上海 200433
*通信作者) |
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| 摘要: |
| 目的 探讨静脉溶栓治疗急性缺血性脑卒中时假卒中的临床特征及其鉴别。方法 回顾性分析第二军医大学长海医院2013年9月至2015年2月静脉溶栓、明确诊断假卒中患者的临床资料，并与缺血性脑卒中患者进行比较，分析两组患者临床表现与实验室检查结果的差异。结果 静脉溶栓患者212例，明确假卒中患者7例（3.3%），与缺血性脑卒中患者比较，两组患者基线数据无明显差异，精神心理障碍和痴呆病史对鉴别假卒中具有重要价值，头颅MRI、血管评估、脑电图、血液和脑脊液检查有助于明确假卒中的最后诊断。结论 少数静脉溶栓治疗的患者最后诊断为假卒中，患者病史结合头颅MRI对鉴别诊断具有重要价值。 |
| 关键词: 脑梗死 血栓溶解疗法 假卒中 |
| DOI：10.16781/j.0258-879x.2016.10.1222 |
| 投稿时间：2016-04-26修订日期：2016-10-08 |
| 基金项目:上海市科委医学引导项目（124119a8900），上海申康医院发展中心临床管理优化项目（SHDC2015607）. |
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| Clinical characteristics and differentiation of stroke mimics during super early intravenous thrombolysis of acute ischemic stroke |
| CHEN Lei,ZHU Xuan,ZHANG Ping,ZHANG Min-min,JIANG Yi,XING Peng-fei,ZHANG Yong-wei,WU Tao,DENG Ben-qiang* |
(Stroke Center, Changhai Hospital, Second Military Medical University, Shanghai 200433, China
*Corresponding author) |
| Abstract: |
| Objective To study the clinical characteristics and differentiation of stroke mimics during super early intravenous thrombolysis of acute ischemic stroke. Methods The clinical data of patients who received intravenous thrombolysis between Sep. 2013 and Feb. 2015 in Changhai Hospital were retrospectively analyzed. And those with stroke mimics were identified and were compared with those with strokes; the clinical symptoms and laboratory findings were compared between the two groups. Results A total of 212 patients received intravenous thrombolysis, and 7 (3.3%) of them were identified as having stroke mimics. There were no notable differences in the baseline characteristics between mimics and stroke groups. Psychiatric and dementia history were of great value for differentiation of stroke mimics from strokes. MRI, vascular assessment, electroencephalogram (EEG), blood and cerebrospinal fluid assay greatly contributed to the final diagnosis of stroke mimics. Conclusion Only few patients receiving intravenous thrombolysis have been confirmed to have stroke mimics. Medical history combined with MRI may be of great value for differentiation of mimics and strokes. |
| Key words: brain infarction thrombolytic therapy stroke mimics |
