Zhuo X W, Li J W, Meng L B, Xiong H, Fang F, Zou L P, Yu Z M
Department of Neurology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China.
Department of Cardiology, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing 102218, China.
Zhonghua Yi Xue Za Zhi. 2024 Aug 13;104(31):2875-2880. doi: 10.3760/cma.j.cn112137-20240408-00816.
The etiology of childhood arterial ischemic stroke is complex, and identifying the underlying cause is crucial for optimizing treatment and preventing recurrence. Currently, the classification methods for childhood arterial ischemic stroke are largely based on data from international studies, but a unified consensus have not yet been reached. This paper reviews the existing classification methods and their subtype definitions, and points out some doubts and ambiguities. On this basisi, combined with the data collected by Beijing Children's Hospital on Chinese children with arterial ischemic stroke, a new classification method (COIST) was proposed according to the etiology and pathogenesis, namely: inflammation (I), abnormal vascular structure (S), thrombophilia (T), heart disease (C), other identifiable causes (O), and uncertain causes; and various subtypes are listed. It is hoped that this new classification method can attract the attention and discussion of domestic colleagues, with the aim of further refinement, in order to help clinicians better understand and quickly identify the etiologies of childhood ischemic stroke.
儿童动脉缺血性卒中的病因复杂,明确潜在病因对于优化治疗和预防复发至关重要。目前,儿童动脉缺血性卒中的分类方法主要基于国际研究数据,但尚未达成统一共识。本文回顾了现有的分类方法及其亚型定义,并指出了一些疑问和模糊之处。在此基础上,结合北京儿童医院收集的中国儿童动脉缺血性卒中数据,根据病因和发病机制提出了一种新的分类方法(COIST),即:炎症(I)、血管结构异常(S)、易栓症(T)、心脏病(C)、其他可识别病因(O)以及病因不明;并列出了各种亚型。希望这种新的分类方法能够引起国内同行的关注和讨论,以期进一步完善,帮助临床医生更好地理解和快速识别儿童缺血性卒中的病因。