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[不明来源栓塞性卒中(ESUS)]

[ESUS (embolic stroke of undetermined sources)].

作者信息

Kitagawa Kazuo

出版信息

Nihon Rinsho. 2016 Apr;74(4):597-602.

Abstract

Cryptogenic stroke is one-fourth among cerebral infarction, but most of them could be ascribed to embolic stroke. ESUS was proposed for unifying embolic stroke of undetermined sources by Hart et al. in 2014. The etiologies underlying ESUS included minor-risk potential cardioembolic sources, covert paroxysmal atrial fibrillation, cancer-associated coagulopathy and embolism, arteriogenic emboli, and paroxysmal embolism. Extensive evaluation including transesophageal echocardiography and cardiac monitoring for long time could identify the etiology of these patients. Although anti-platelet drug is recommended in ESUS in the current guideline, clinical trials are ongoing to determine the efficacy of non-vitamin K antagonist oral anticoagulant in ESUS patients.

摘要

隐源性卒中在脑梗死中占四分之一,但其中大多数可归因于栓塞性卒中。2014年,哈特等人提出了“不明来源栓塞性卒中(ESUS)”这一术语,用于统一不明来源的栓塞性卒中。ESUS的潜在病因包括低风险的心源性栓塞来源、隐匿性阵发性心房颤动、癌症相关凝血病和栓塞、动脉源性栓子以及阵发性栓塞。包括经食管超声心动图和长时间心脏监测在内的广泛评估可以确定这些患者的病因。尽管目前的指南推荐在ESUS患者中使用抗血小板药物,但仍有临床试验正在进行,以确定非维生素K拮抗剂口服抗凝剂在ESUS患者中的疗效。

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