华法林相关性脑出血与脑微血管病变的关系

摘要/Abstract

摘要：

随着人口老龄化及临床上口服抗凝药物应用增多，口服抗凝药相关性脑出血（oral anticoagulant therapy related intracerebral hemorrhage，OAC-ICH）也急剧增加，早期病死率高达50％。在抗凝治疗范围内，OAC-ICH发病率的增加与年龄增长和既往卒中病史相关。此外，OAC-ICH发病可能还与某些个人因素相关，例如与年龄相关的大脑小血管病变相关。脑白质疏松（leukoaraiosis，LA）和脑微出血（cerebral microbleeds，CMBs）是两种重要脑小血管病。LA和CMBs在OAC-ICH患者中患病率较高。本文就OAC-ICH与LA及CMBs的关系做一综述，以指导临床口服抗凝药应用，避免部分OAC-ICH的发生。

文章导读： 脑白质疏松和脑微出血可能是预测口服OAC-ICH重要指标，对指导临床口服抗凝药的应用及预防OAC-ICH具有重要意义。

关键词: 脑出血; 口服抗凝药; 国际标准化比值; 脑白质疏松; 脑微出血

Abstract:

As the population aging and the clinical application of oral anticoagulation drugs are increasing, oral anticoagulant therapy related intracerebral hemorrhage(OAC-ICH) also increases sharply, and its early mortality is as high as 50%. The increased incidence of OAC-ICH is associated with increased age and previous stroke within the anticoagulant therapeutic range. Besides, it is likely that the pathogenesis of OAC-ICH is related to some of individual factors, for example, an age-related disorder of small brain blood vessels. Leukoaraiosis(LA) and cerebral microbleeds(CMBs) are two important brain small vascular diseases. The morbidity of LA and CMBs in the OAC-ICH patients is high. This article reviews the relationship between OAC-ICH, LA, CMBs in order to guide the clinical application of oral anticoagulants and prevent the occurrence of partial OAC-ICH.

Key words: Intracerebral hemorrhage; Oral anticoagulant; International normalized ratio; Leukoaraiosis; Cerebral microbleeds

罗小娜，杨磊，胡文立. 华法林相关性脑出血与脑微血管病变的关系[J]. 中国卒中杂志, 2013, 8(03): 197-201.

LUO Xiao-Na, YANG lei, HU Wen-Li.. Relationship Between Warfarin Related Intracerebral Hemorrhage and Cerebral Microbleeds[J]. Chinese Journal of Stroke, 2013, 8(03): 197-201.

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