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[韩国当前的中风管理]

[Management of stroke in Korea, now].

作者信息

Roh Jae-Kyu, Song Eun-Cheol

机构信息

Seoul National Univ. Hospital, 28, Yongon-Dong, Chongro-Gu Seoul, 110-744, South Korea.

出版信息

Rinsho Shinkeigaku. 2006 Nov;46(11):781-7.

Abstract

Korea is a rapidly growing aging society and stroke is still the second cause of death, comprised of about 15% of the total death in Korea. But the mortality of stroke is slightly decreasing despite increase of stroke incidence, probably due to improvement of management of stroke and related risk factors. The advent of DWI/ MRA enables us to make more accurate patho-etiological diagnoses of ischemic strokes. With the findings in DWI/ MRA and the new classification policy that entrusts the final judgment to stroke specialists of each hospital, we could further classify the large artery disease of the TOAST classification into in-situ thrombosis, artery to artery embolism, and low-flow infarction and make the most plausible diagnosis of undetermined etiology in the TOAST classification. In this article we reviewed medical and surgical treatment of stroke, especially focusing the clinical practice in Korea. We also provided our results of in vivo experiments with promising drugs and stem cells, too. In conclusion, there are too many uncertain areas of stroke managements yet to be settled. We need larger clinical data pools that are collected based on accurate etiological diagnoses of stroke subtypes on the one hand, and brilliant basic research on the other.

摘要

韩国是一个老龄化迅速加剧的社会,中风仍是第二大致死原因,约占韩国总死亡人数的15%。尽管中风发病率有所上升,但其死亡率仍略有下降,这可能得益于中风及相关危险因素管理的改善。弥散加权成像/磁共振血管造影(DWI/MRA)的出现使我们能够对缺血性中风做出更准确的病理病因诊断。根据DWI/MRA的检查结果以及将最终诊断权委托给各医院中风专家的新分类政策,我们可以将TOAST分类中的大动脉疾病进一步细分为原位血栓形成、动脉到动脉栓塞和低灌注梗死,并对TOAST分类中病因不明的情况做出最合理的诊断。在本文中,我们回顾了中风的内科和外科治疗,尤其关注韩国的临床实践。我们还提供了使用有前景的药物和干细胞进行体内实验的结果。总之,中风管理仍有太多不确定领域有待解决。一方面,我们需要基于中风亚型准确病因诊断收集的更大规模临床数据库,另一方面,也需要出色的基础研究。

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