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中国颈脑动脉夹层研究(CCADS):一项多中心前瞻性队列研究的原理与方案

Chinese Cervicocephalic artery dissection study (CCADS): rationale and protocol for a multicenter prospective cohort study.

作者信息

Zhu Zhu, Xu Yuyuan, Wang Yilong, Zhou Zhenhua, Han Xiang, Liu Aihua, Peng Jing, Xu Yi, Wang Luyao

机构信息

Department of Neurology, State Key Laboratory of Medical Neurobiology, Huashan Hospital, Fudan University, Shanghai, China.

Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.

出版信息

BMC Neurol. 2018 Jan 11;18(1):6. doi: 10.1186/s12883-018-1011-x.

Abstract

BACKGROUND

Cervicocephalic artery dissection (CAD) is an important etiology of stroke in the youth. Findings from recent studies suggest it a "group of disease entities" with different underlying etiologies, presentations and prognosis, necessitating an integral study including various types of CAD to get a better understanding of this disease. In addition, Chinese patients with CAD are likely to carry different features from their western counterparts, which remains uncertain yet. Chinese Cervicocephalic Artery Dissection Study (CCADS) therefore aims at exploring the epidemiology, risk factors, clinical/radiological features, diagnosis and prognosis of CAD in Chinese patients.

METHODS/DESIGN: CCADS is a multicenter prospective cohort study enrolling patients age ≥ 18 years with recent (<14 days after onset) CAD. Baseline clinical data, laboratory tests and imaging studies are performed within 3 days after admission, and follow-ups will be conducted through face-to-face interviews at discharge, 3 months, 6 months and 12 months after admission, when the modified Rankin Scale (mRS), cerebrovascular events, medication compliance, CAD evolution and so on are evaluated. Additional blood samples will also be collected at baseline, 3 and 12 months follow-up. The primary outcome is radiographic evolution of CAD; secondary outcomes include cerebrovascular events, major bleeding complications, all-cause mortality and functional independence.

DISCUSSION

Through the integration of information on epidemiology, risk factors, clinical/radiological features and prognosis of various types of CAD in Chinese population, combined with the application of advanced imaging techniques, collection of potential blood biomarkers, and assessment of novel treatment strategies. CCADS will provide thorough information on CAD - the major cause of stroke in the youth, and play a role in prevention and treatment determination in the future.

摘要

背景

头颈部动脉夹层(CAD)是青年卒中的重要病因。近期研究结果表明,它是一组具有不同潜在病因、临床表现和预后的“疾病实体”,因此需要进行综合研究,包括各种类型的CAD,以便更好地了解这种疾病。此外,中国CAD患者可能具有与西方患者不同的特征,但这一点仍不确定。因此,中国头颈部动脉夹层研究(CCADS)旨在探索中国CAD患者的流行病学、危险因素、临床/放射学特征、诊断和预后。

方法/设计:CCADS是一项多中心前瞻性队列研究,纳入年龄≥18岁、近期(发病后<14天)发生CAD的患者。入院后3天内进行基线临床数据、实验室检查和影像学研究,并在出院时、入院后3个月、6个月和12个月通过面对面访谈进行随访,评估改良Rankin量表(mRS)、脑血管事件、药物依从性、CAD演变等情况。在基线、随访3个月和12个月时还将采集额外的血样。主要结局是CAD的影像学演变;次要结局包括脑血管事件、严重出血并发症、全因死亡率和功能独立性。

讨论

通过整合中国人群中各种类型CAD的流行病学、危险因素、临床/放射学特征和预后信息,结合先进影像学技术的应用、潜在血液生物标志物的收集以及新型治疗策略的评估,CCADS将提供有关CAD(青年卒中的主要病因)的全面信息,并在未来的防治决策中发挥作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b0a6/5765701/fc772fecb5f6/12883_2018_1011_Fig1_HTML.jpg

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