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低灌注在预测复发性短暂性脑缺血发作中的作用:一项前瞻性队列研究方案

Power of Hypoperfusion in Predicting Recurrent Transient Ischemic Attacks: Protocol of a Prospective Cohort Study.

作者信息

Wang Yue, Liang Huazheng, Jin Lingjing, Wang Shaoshi

机构信息

Department of Neurology, Shanghai Fourth People's Hospital Affiliated to Tongji University School of Medicine, Shanghai, China.

Department of Neurology, Translational Research Institute of Brain and Brain-Like Intelligence, Shanghai Fourth People's Hospital Affiliated to Tongji University School of Medicine, Shanghai, China.

出版信息

Front Hum Neurosci. 2021 Jun 24;15:654383. doi: 10.3389/fnhum.2021.654383. eCollection 2021.

Abstract

Transient ischemic attack (TIA) has a high incidence of recurrent vascular events. Hypoperfusion is one of the factors that are closely correlated with 7-day recurrence of TIA. This study aimed to evaluate the power of hypoperfusion shown on magnetic resonance (MR) perfusion imaging in predicting the incidence of 7-day recurrence of ischemic events after TIA. REATTACK is a prospective multi-centered cohort study on the correlation between MR perfusion and TIA recurrence. Ninety patients aged ≥18 years with recent (<7 days after onset) clinical TIA will be continuously included. All the patients will undergo diffusion-weighted imaging (DWI) and perfusion-weighted imaging (PWI) assessments within 24 h after the onset of TIA. The subjects will then be divided into a PWI positive group and a PWI negative group according to the time-to-maximum of the residue function ( ). PWI will be repeated after 7 days and in 3 months. The primary clinical outcome will be the recurrence of TIA within 7 days after the onset of TIA. Secondary outcomes will be the recurrence of TIA in 3 months and modified Rankin scale (mRS) score. A chi-square test will be performed to compare the difference in the incidence of recurrent TIA between the two groups, and rank sum test in the mRS score. Multivariate logistic regression will be simultaneously performed to analyze the risk factors for the recurrence of TIA. The results of this study will confirm whether abnormal helps to identify the patients with TIA who have high risks of recurrent ischemic events. This would largely improve the prognosis of patients with TIA. www.chictr.org.cn, registration number: ChiCTR2000031863, registered on 12 April 2020.

摘要

短暂性脑缺血发作(TIA)后血管事件复发率很高。灌注不足是与TIA 7天复发密切相关的因素之一。本研究旨在评估磁共振(MR)灌注成像显示的灌注不足对预测TIA后缺血事件7天复发发生率的作用。REATTACK是一项关于MR灌注与TIA复发相关性的前瞻性多中心队列研究。将持续纳入90例年龄≥18岁、近期(发病后<7天)发生临床TIA的患者。所有患者将在TIA发作后24小时内接受弥散加权成像(DWI)和灌注加权成像(PWI)评估。然后根据残余函数的达峰时间将受试者分为PWI阳性组和PWI阴性组。7天后和3个月后重复进行PWI检查。主要临床结局为TIA发作后7天内TIA复发。次要结局为3个月内TIA复发及改良Rankin量表(mRS)评分。将进行卡方检验以比较两组间TIA复发发生率的差异,对mRS评分进行秩和检验。将同时进行多因素logistic回归分析TIA复发的危险因素。本研究结果将证实残余函数异常是否有助于识别有缺血事件复发高风险的TIA患者。这将在很大程度上改善TIA患者的预后。 中国临床试验注册中心,注册号:ChiCTR2000031863,于2020年4月12日注册。

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本文引用的文献

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History of Hypertension Is Associated With MR Hypoperfusion in Chinese Inpatients With DWI-Negative TIA.
Front Neurol. 2019 Aug 14;10:867. doi: 10.3389/fneur.2019.00867. eCollection 2019.
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Int J Stroke. 2019 Jul;14(5):460-467. doi: 10.1177/1747493018823568. Epub 2019 Jan 11.
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