短暂性脑缺血发作新进展

摘要/Abstract

摘要：

短暂性脑缺血发作（transient ischemic attack，TIA）是常见的缺血性脑血管病之一，但其诊断、治疗中仍存在许多争议。磁共振成像（magnetic resonance imaging，MRI）/弥散加权成像（diffusion weighted imaging，DWI）检查在TIA诊断中是否必要；TIA患者是否应住院治疗；TIA后的抗血小板治疗应单用阿司匹林还是阿司匹林联合氯吡格雷；心源性TIA后何时开始抗凝治疗最合适；TIA的二级预防对减少卒中的发生至关重要，如何做好二级预防，避免误诊、误治的发生；几种较为特殊的TIA发病率较低，如何尽快明确诊断，这些问题值得临床医师重视。本文对上述有关临床研究进行总结，结合国内外指南，对这些问题的最新进展作一综述，以期帮助大家更科学地了解TIA的诊断及治疗。

文章导读： 本文针对DWI在TIA诊断中的应用，是否应住院治疗，抗血小板、抗凝治疗及几种特殊类型的TIA等
方面做了简要介绍，以期帮助大家更科学地了解TIA的诊断及治疗。

关键词: 短暂性脑缺血发作; 影像; 住院治疗; 抗血小板; 抗凝; 特殊类型

Abstract:

Transient ischemic attack (TIA) is one of the most common ischemic cerebrovascular diseases, but there are still disputes in its diagnosis and treatment. Is magnetic resonance imaging (MRI)/diffusion weighted imaging (DWI) examination necessary in the diagnosis of TIA; whether patients with TIA should be hospitalized; Dual or mono antiplatelet therapy which is better after TIA; what is the best time of anticoagulant treatment after cardiogenic TIA; secondary prevention of TIA is essential, how to offer a proper secondary prevention and avoid misdiagnosis and mistreatment; some special type of TIA is relatively rare, how to diagnose quickly, these issues deserve clinicians’ attention. This paper summarizes the related clinical research, combined with domestic and international guidelines, and also reviews the latest progress on these issues with the aim of helping the clinicians to understand the diagnosis and treatment of TIA more scientifically.

Key words: Transient ischemic attack; Image; Hospitalization; Antiplatelet; Anticoagulation; Special type

黄维，毕齐. 短暂性脑缺血发作新进展[J]. 中国卒中杂志, 2014, 9(10): 874-879.

HUANG Wei, BI Qi.. New Progress in Transient Ischemic Attack[J]. Chinese Journal of Stroke, 2014, 9(10): 874-879.

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