High Risk Non-disabling Ischemic Cerebrovascular Events and Cognitive Impairment

doi:10.3969/j.issn.1673-5765.2017.12.011

Abstract

Abstract:

Ischemic cerebrovascular disease (ICD) is a kind of cerebral vascular diseases which has high fatality rate and disability rate. ICD is divided into disabling ischemic cerebrovascular event (DICE) and non-disabling ischemic cerebrovascular events (NICE). NICE people are usually not taken seriously, however a large proportion of them are in an unstable state and relapse into severe stroke over a period of time, which is known as high risk non-disabling cerebrovascular events (HR-NICE). Cognitive impairment caused by HR-NICE is a common complication and affects the quality of life and survival time seriously. Therefore, it is of important clinical significance to identify of HR-NICE people and intervene at early stage. This paper is to review the definition, epidemiology, clinical features, evaluation methods and comprehensive intervention methods of HR-NICE, so as to improve the diagnostic and therapeutic level as well as the survival quality of patient.

Key words: High risk non-disabling ischemic cerebrovascular events; Cognitive impairment;Review

摘要：

缺血性脑血管病是一种病死率及致残率相当高的脑血管疾患，分为致残性缺血性脑血管事件（disabling ischemic cerebrovascular events，DICE）和非致残性缺血性脑血管事件（non-disabling ischemic cerebrovascular events，NICE）。NICE通常不被重视，但很大比例的NICE人群处于不稳定状态，在一段时间内复发成严重的卒中，称为高危非致残性缺血性脑血管事件（high risk non-disabling ischemic cerebrovascular events，HR-NI CE），而且HR-NICE后认知功能障碍是常见的并发症，严重影响患者生活质量及生存时间，因此尽早识别HR-NICE患者，积极进行综合干预具有十分重要的临床意义。本文对HR-NICE及HR-NICE所致认知障碍的定义、流行病学、临床特点、评估方法及综合干预手段进行综述，以期提高其诊断治疗水平，改善患者生存质量。

关键词: 高危非致残性缺血性脑血管病; 认知障碍; 综述

ZHOU Zhi-Wei,MA Meng-Meng, HE Li. High Risk Non-disabling Ischemic Cerebrovascular Events and Cognitive Impairment[J]. Chinese Journal of Stroke, 2017, 12(12): 1123-1126.

周知微，马萌萌，何俐. 高危非致残性缺血性脑血管事件与认知障碍[J]. 中国卒中杂志, 2017, 12(12): 1123-1126.

References

[1] 王伊龙，赵性泉，刘新峰，等. 高危非致残性缺血性脑血管

事件诊疗指南[J]. 中国卒中杂志，2016，11（6）：481-491.

[2] MORAN G M，FLETCHER B，FELTHAM M G，et al.

Fatigue，psychological and cognitive impairment following

transient ischaemic attack and minor stroke：a systematic

review[J]. Eur J Neurol，2014，21（10）：1258-1267.

[3] WANG Y，ZHAO X，JIANG Y，et al. Prevalence，

knowledge，and treatment of transient ischemic attacks in

China[J]. Neurology，2015，84（23）：2354-2361.

[4] HU X Y，ZHANG M，WANG D M，et al. Prevalence

of carotid artery stenosis in southern China：a

retrospective，cross-sectional study[J]. Int J Stroke，

2013，8（6）：E31-E32. DOI：10.1111/ijs.12078.

http://xueshu.baidu.com/s?wd=paperuri%3A%28

730439bc7f58b1b67f282c982fa8ebd6%29&filter=

sc_long_sign&tn=SE_xueshusource_2kduw22v&sc_

vurl=http%3A%2F%2Fonlinelibrary.wiley.com%2F

doi%2F10.1111%2Fijs.12078%2Ffull&ie=utf-8&sc_

us=10166408423228233308.

[5] LI S M，LI D，LING F，et al. Carotid artery stenting：

experience of a single institute in china[J]. Interv

Neuroradiol，2005，11（3）：205-212.

[6] VAN ROOIJ F G，SCHAAPSMEERDERS

P，MAAIJWEE N A，et al. Persistent cognitive

impairment after transient ischemic attack[J]. Stroke，

2014，45（8）：2270-2274.

[7] NARASIMHALU K，ANG S，DE SILVA D A，et

al. Severity of CIND and MCI predict incidence of

dementia in an ischemic stroke cohort[J]. Neurology，

2009，73（22）：1866-1872.

[8] PENDLEBURY S T，ROTHWELL P M. Prevalence，

incidence，and factors associated with pre-stroke and

post-stroke dementia：a systematic review and metaanalysis[

J]. Lancet Neurol，2009，8（11）：1006-1018.

[9] DANOVSKA M，STAMENOV B，

ALEXANDROVA M，et al. Post-stroke cognitive

impairment – phenomenology and prognostic

factors[J]. Journal of IMAB - Annual Proceeding

（Scientific Papers），2012，18（3）：290-297.

[10] 中国卒中学会，卒中后认知障碍管理专家委员会. 卒

中后认知障碍管理专家共识[J]. 中国卒中杂志，2017，

12（6）：519-531.

[11] JIA J，WEI C，LIANG J，et al. The effects of DL-3-

n-butylphthalide in patients with vascular cognitive

impairment without dementia caused by subcortical

ischemic small vessel disease：A multicentre，

randomized，double-blind，placebo-controlled

trial[J]. Alzheimers Dement，2016，12（2）：89-99.

[12] TAN M S，YU J T，TAN C C，et al. Efficacy and

adverse effects of ginkgo biloba for cognitive

impairment and dementia：a systematic review and

meta-analysis[J]. J Alzheimers Dis，2015，43（2）：

589-603.

[13] BALLARD C，SAUTER M，SCHELTENS P，et

al. Efficacy，safety and tolerability of rivastigmine

capsules in patients with probable vascular dementia：

the VantagE study[J]. Curr Med Res Opin，2008，24

（9）：2561-2574.

[14] ROYALL D R，CORDES J A，ROMÁN G，et

al. Sertraline improves executive function in

patients with vascular cognitive impairment[J]. J

Neuropsychiatry Clin Neurosci，2009，21（4）：445-

454.