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颅内动脉粥样硬化狭窄患者强化瑞舒伐他汀治疗卒中/短暂性脑缺血发作的脑血流评估研究:原理和设计。

Cerebral blood flow evaluation of intensive rosuvastatin therapy in stroke/transient ischemic attack patients with intracranial arterial atherosclerotic stenosis study: Rationale and design.

机构信息

Department of Neurology School of Medicine The Second Affiliated Hospital of Zhejiang University Hangzhou China.

Department of Radiology School of Medicine The Second Affiliated Hospital of Zhejiang University Hangzhou China.

出版信息

Brain Behav. 2017 Apr 28;7(6):e00689. doi: 10.1002/brb3.689. eCollection 2017 Jun.

Abstract

INTRODUCTION

The risk of recurrent stroke is high in patients with intracranial atherosclerotic stenosis (ICAS). Statin use has been demonstrated to decrease the incidence of stroke by reducing atherosclerotic plaque burden. However, its effect on the hemodynamic situation and cerebral perfusion status has not yet been validated. With the use of computed tomography perfusion (CTP), we aim to evaluate the impact of Rosuvastatin on cerebral hemodynamic changes, as well as the downstream perfusion.

METHOD

Cerebral bood flow evaluation of intensive rosuvastatin therapy in patients with intracranial arterial atherosclerotic stenosis (CEIRIS) is a single-center, prospective, randomized, parallel-group, and open-label trial, and it will include 50 participants as estimated. Patients with moderate to severe (50%-99%) ICAS are randomized 1:1 to 10 mg/day or 20 mg/day Rosuvastatin and followed every 13 weeks until 52 weeks. The primary outcome for the trial is the change in the relative regional cerebral blood flow evaluated by CTP after 52 weeks of Rosuvastatin treatment. The secondary outcomes are cerebral blood volume, change in the degree of stenosis of the target vessel and lipid parameters.

CONCLUSION

The CEIRIS trial about the effects of statin on the temporal hemodynamic progression of ICAS may extend our understanding of the basic pathophysiology and mechanisms of stroke in ICAS patients.

摘要

简介

颅内动脉粥样硬化性狭窄(ICAS)患者的复发卒中风险较高。他汀类药物的使用已被证明通过减少动脉粥样硬化斑块负担来降低卒中的发生率。然而,其对血液动力学状况和脑灌注状态的影响尚未得到验证。我们使用计算机断层灌注(CTP)来评估瑞舒伐他汀对脑血液动力学变化以及下游灌注的影响。

方法

强化瑞舒伐他汀治疗颅内动脉粥样硬化性狭窄患者的脑血流评估(CEIRIS)是一项单中心、前瞻性、随机、平行组、开放标签试验,预计将纳入 50 名参与者。将 50%-99%的中度至重度 ICAS 患者随机分为 1:1 组,分别接受 10mg/天或 20mg/天的瑞舒伐他汀治疗,并每 13 周随访一次,直至 52 周。该试验的主要结局是在 52 周瑞舒伐他汀治疗后,通过 CTP 评估相对区域性脑血流的变化。次要结局是脑血容量、目标血管狭窄程度的变化和血脂参数。

结论

CEIRIS 试验关于他汀类药物对 ICAS 时间血液动力学进展的影响,可能会扩展我们对 ICAS 患者中风基本病理生理学和机制的理解。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/be3d/5474700/07008a75a603/BRB3-7-e00689-g001.jpg

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