Relationship between the ischemic stroke subtypes and risk factors included clinical outcome from Prasat Neurological Institute stroke registry
คำสำคัญ:
Stroke, Stroke subtypesบทคัดย่อ
โรคหลอดเลือดสมองตีบแต่ละชนิดมีความแตกต่างกัน การศึกษานี้มีจุดประสงค์เพื่อหาความสัมพันธ์ของโรคหลอดเลือดสมองแต่ละชนิด กับปัจจัยเสี่ยง ความรุนแรง การรักษาในระยะเฉียบพลัน ภาวะแทรกซ้อน และผลการรักษา วิธีการศึกษา เป็นการศึกษาชนิดไปข้างหน้า จากทะเบียนผู้ป่วยโรคหลอดเลือดสมองของสถาบันประสาทวิทยาโดยแยกประเภทตาม TOAST stroke subtypes: small vessel atherosclerosis (SAO), large vessel atherosclerosis (LAA), cardiac embolism (CE), other determined etiology (OD), other undetermined etiology (UND) จากนั้นนำข้อมูลมาหาความสัมพันธ์ทางสถิติโดยใช้ Fisher’s Exact Test หรือ Kruskal-Wallis Test ผลการศึกษา ผู้ป่วยทั้งหมด 140 คน ผู้ป่วยร้อยละ 45, 34.3, 12.9, 4.3, และ 3.6 ได้รับการจำแนกประเภทเป็น SAO, LAA, CE, OD, UND ตามลำดับ และพบว่าอายุ ความรุนแรงของโรค การรักษา ภาวะแทรกซ้อน และผลการรักษาสัมพันธ์กับชนิดของโรคหลอดเลือดสมองตีบอย่างมีนัยสำคัญทางสถิติ (p< 0.001) โรคหลอดเลือดสมองชนิด CE มีค่าเฉลี่ยของอายุ median มากที่สุด (68.5 ปี) และมีภาวะแทรกซ้อนจากสมองบวม กับการเกิดเลือดออกในบริเวณที่มีสมองตายได้บ่อย (ร้อยละ 22) สรุป ปัจจัยด้านอายุ ความรุนแรงของโรค วิธีการรักษา และผลการรักษาทางคลินิก มีความแตกต่างกันตามชนิดของโรคหลอดเลือดสมองตีบ ดังนั้นการรักษาและการป้องกันควรพิจารณาตามแต่ละชนิดของโรคหลอดเลือดสมองตีบ
เอกสารอ้างอิง
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Gunarathne A, Patel JV, Gammon B, et al. Ischemic stroke in South Asians: a review of the epidemiology, pathophysiology, and ethnicity-related clinical
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Turin TC, Kita Y, Rumana N, et al. Ischemic stroke subtypes in a Japanese population: Takashima Stroke Registry, 1988-2004. Stroke 2010;41:1871-1876.
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Hanchaiphiboolkul S. Risk factors for early infection after an acute cerebral infarction. J Med Assoc Thai 2005;88:150-155.
Chinwatanakul S, Boonyapisit K, Pornsriniyom D, Proyoonwiwat N, Senanarong V, Chaisevikul R, et al. Siriraj Acute Stroke Unit: 10 years experience. J Med Assoc Thai 2012;95 Suppl 2:S235-244.
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Grau AJ, Weimar C, Buggle F, et al. Risk factors, outcome, and treatment in subtypes of ischemic stroke: the German stroke data bank. Stroke 2001;32:2559-2566.
Murat Sumer M, Erturk O. Ischemic stroke subtypes: risk factors, functional outcome and recurrence. Neurol Sci 2002;22:449-454.
White H, Boden-Albala B, Wang C, et al. Ischemic stroke subtype incidence among whites, blacks, and Hispanics: the Northern Manhattan Study. Circulation
2005;111:1327-1331.
Ohira T, Shahar E, Chambless LE, et al. Risk factors for ischemic stroke subtypes: the Atherosclerosis Risk in Communities study. Stroke 2006;37:2493-2498.
Bejot Y, Caillier M, Ben Salem D, et al. Ischaemic stroke subtypes and associated risk factors: a French population based study. J Neurol Neurosurg Psychiatry 2008;79:1344-1348.
Michel P, Odier C, Rutgers M, et al. The Acute STroke Registry and Analysis of Lausanne (ASTRAL): design and baseline analysis of an ischemic stroke registry
including acute multimodal imaging. Stroke 2010;41:2491-2498.
Ihle-Hansen H, Thommessen B, Wyller TB, et al. Risk factors for and incidence of subtypes of ischemic stroke. Functional neurology. 2012;27:35-40.
Lavados PM, Sacks C, Prina L, et al. Incidence, case-fatality rate, and prognosis of ischaemic stroke subtypes in a predominantly Hispanic-Mestizo population in Iquique, Chile (PISCIS project): a community-based incidence study. Lancet Neurol 2007;6:140-148.
Seet RC, Friedman PA, Rabinstein AA. Prolonged rhythm monitoring for the detection of occult paroxysmal atrial fibrillation in ischemic stroke of unknown cause. Circulation 2011;124:477-486.
Lisabeth LD, Brown DL, Hughes R, et al. Acute stroke symptoms: comparing women and men. Stroke 2009;40:2031-2036.
Tanizaki Y, Kiyohara Y, Kato I, et al. Incidence and risk factors for subtypes of cerebral infarction in a general population: the Hisayama study. Stroke 2000;31:2616-2622.
Jackson C, Sudlow C. Are lacunar strokes really different? A systematic review of differences in risk factor profiles between lacunar and nonlacunar infarcts. Stroke 2005;36:891-901.
Air EL, Kissela BM. Diabetes, the metabolic syndrome, and ischemic stroke: epidemiology and possible mechanisms. Diabetes care 2007;30:3131-3140.
Navaratna D, Guo SZ, Hayakawa K, et al. Decreased cerebrovascular brain-derived neurotrophic factor-mediated neuroprotection in the diabetic brain. Diabetes 2011;60:1789-1796.
Bowman TS, Sesso HD, Ma J, et al. Cholesterol and the risk of ischemic stroke. Stroke 2003;34:2930-2934.
Tirschwell DL, Smith NL, Heckbert SR,et al. Association of cholesterol with stroke risk varies in stroke subtypes and patient subgroups. Neurology 2004;63:1868-1875.
Laloux P, Galanti L, Jamart J. Lipids in ischemic stroke subtypes. Acta Neurol Belg 2004;104:13-19.
Oksala NK, Heikkinen M, Mikkelsson J, et al. Smoking and the platelet fibrinogen receptor glycoprotein IIb/IIIA PlA1/A2 polymorphism interact in the risk of lacunar stroke and midterm survival. Stroke 2007;38:50-55.
Peters SA, Huxley RR, Woodward M. Smoking as a risk factor for stroke in women compared with men: a systematic review and meta-analysis of 81 cohorts,
including 3,980,359 individuals and 42,401 strokes. Stroke 2013;44:2821-2828.
Kim J, Gall SL, Dewey HM, et al. Baseline smoking status and the long-term risk of death or nonfatal vascular event in people with stroke: a 10-year
survival analysis. Stroke 2012;43:3173-3178.
Djousse L, Ellison RC, Beiser A, et al. Alcohol consumption and risk of ischemic stroke: The Framingham Study. Stroke 2002;33:907-912.
Mostofsky E, Burger MR, Schlaug G, et al. Alcohol and acute ischemic stroke onset: the stroke onset study. Stroke 2010;41:1845-1849.
Mohsenin V. Sleep-related breathing disorders and risk of stroke. Stroke 2001;32:1271-1278.
Jood K, Jern C, Wilhelmsen L, et al. Body mass index in mid-life is associated with a first stroke in men: a prospective population study over 28 years.
Stroke 2004;35:2764-2769.
Park JW, Lee SY, Kim SY, et al. BMI and stroke risk in Korean women. Obesity 2008;16:396-401.
Sandercock P, Bamford J, Dennis M, et al. Atrial fibrillation and stroke: prevalence in different types of stroke and influence on early and long term prognosis (Oxfordshire community stroke project). BMJ 1992;305:1460-1465.
Jorgensen HS, Nakayama H, Reith J, et al. Acute stroke with atrial fibrillation. The Copenhagen Stroke Study. Stroke 1996;27:1765-1769.
Lin HJ, Wolf PA, Kelly-Hayes M, et al. Stroke severity in atrial fibrillation. The Framingham Study. Stroke 1996;27:1760-1764.
Hornig CR, Bauer T, Simon C, et al. Hemorrhagic transformation in cardioembolic cerebral infarction. Stroke 1993;24:465-468.
Molina CA, Montaner J, Abilleira S, et al. Timing of spontaneous recanalization and risk of hemorrhagic transformation in acute cardioembolic stroke. Stroke
2001;32:1079-1084.
Dromerick A, Reding M. Medical and neurological complications during inpatient stroke rehabilitation. Stroke 1994;25:358-361.
Roth EJ, Lovell L, Harvey RL, et al. Incidence of and risk factors for medical complications during stroke rehabilitation. Stroke 2001;32:523-529.
Yoneda Y, Uehara T, Yamasaki H, et al. Hospital-based study of the care and cost of acute ischemic stroke in Japan. Stroke 2003;34:718-724.
Gunarathne A, Patel JV, Gammon B, et al. Ischemic stroke in South Asians: a review of the epidemiology, pathophysiology, and ethnicity-related clinical
features. Stroke 2009;40:e415-423.
Turin TC, Kita Y, Rumana N, et al. Ischemic stroke subtypes in a Japanese population: Takashima Stroke Registry, 1988-2004. Stroke 2010;41:1871-1876.
Adams HP, Jr., Bendixen BH, Kappelle LJ, et al. Classification of subtype of acute ischemic stroke. Definitions for use in a multicenter clinical trial. TOAST. Trial of Org 10172 in Acute Stroke Treatment. Stroke 1993;24:35-41.
Hanchaiphiboolkul S. Risk factors for early infection after an acute cerebral infarction. J Med Assoc Thai 2005;88:150-155.
Chinwatanakul S, Boonyapisit K, Pornsriniyom D, Proyoonwiwat N, Senanarong V, Chaisevikul R, et al. Siriraj Acute Stroke Unit: 10 years experience. J Med Assoc Thai 2012;95 Suppl 2:S235-244.
Kolominsky-Rabas PL, Weber M, Gefeller O, et al. Epidemiology of ischemic stroke subtypes according to TOAST criteria: incidence, recurrence, and long-term survival in ischemic stroke subtypes: a population-based study. Stroke 2001;32:2735-2740.
Grau AJ, Weimar C, Buggle F, et al. Risk factors, outcome, and treatment in subtypes of ischemic stroke: the German stroke data bank. Stroke 2001;32:2559-2566.
Murat Sumer M, Erturk O. Ischemic stroke subtypes: risk factors, functional outcome and recurrence. Neurol Sci 2002;22:449-454.
White H, Boden-Albala B, Wang C, et al. Ischemic stroke subtype incidence among whites, blacks, and Hispanics: the Northern Manhattan Study. Circulation
2005;111:1327-1331.
Ohira T, Shahar E, Chambless LE, et al. Risk factors for ischemic stroke subtypes: the Atherosclerosis Risk in Communities study. Stroke 2006;37:2493-2498.
Bejot Y, Caillier M, Ben Salem D, et al. Ischaemic stroke subtypes and associated risk factors: a French population based study. J Neurol Neurosurg Psychiatry 2008;79:1344-1348.
Michel P, Odier C, Rutgers M, et al. The Acute STroke Registry and Analysis of Lausanne (ASTRAL): design and baseline analysis of an ischemic stroke registry
including acute multimodal imaging. Stroke 2010;41:2491-2498.
Ihle-Hansen H, Thommessen B, Wyller TB, et al. Risk factors for and incidence of subtypes of ischemic stroke. Functional neurology. 2012;27:35-40.
Lavados PM, Sacks C, Prina L, et al. Incidence, case-fatality rate, and prognosis of ischaemic stroke subtypes in a predominantly Hispanic-Mestizo population in Iquique, Chile (PISCIS project): a community-based incidence study. Lancet Neurol 2007;6:140-148.
Seet RC, Friedman PA, Rabinstein AA. Prolonged rhythm monitoring for the detection of occult paroxysmal atrial fibrillation in ischemic stroke of unknown cause. Circulation 2011;124:477-486.
Lisabeth LD, Brown DL, Hughes R, et al. Acute stroke symptoms: comparing women and men. Stroke 2009;40:2031-2036.
Tanizaki Y, Kiyohara Y, Kato I, et al. Incidence and risk factors for subtypes of cerebral infarction in a general population: the Hisayama study. Stroke 2000;31:2616-2622.
Jackson C, Sudlow C. Are lacunar strokes really different? A systematic review of differences in risk factor profiles between lacunar and nonlacunar infarcts. Stroke 2005;36:891-901.
Air EL, Kissela BM. Diabetes, the metabolic syndrome, and ischemic stroke: epidemiology and possible mechanisms. Diabetes care 2007;30:3131-3140.
Navaratna D, Guo SZ, Hayakawa K, et al. Decreased cerebrovascular brain-derived neurotrophic factor-mediated neuroprotection in the diabetic brain. Diabetes 2011;60:1789-1796.
Bowman TS, Sesso HD, Ma J, et al. Cholesterol and the risk of ischemic stroke. Stroke 2003;34:2930-2934.
Tirschwell DL, Smith NL, Heckbert SR,et al. Association of cholesterol with stroke risk varies in stroke subtypes and patient subgroups. Neurology 2004;63:1868-1875.
Laloux P, Galanti L, Jamart J. Lipids in ischemic stroke subtypes. Acta Neurol Belg 2004;104:13-19.
Oksala NK, Heikkinen M, Mikkelsson J, et al. Smoking and the platelet fibrinogen receptor glycoprotein IIb/IIIA PlA1/A2 polymorphism interact in the risk of lacunar stroke and midterm survival. Stroke 2007;38:50-55.
Peters SA, Huxley RR, Woodward M. Smoking as a risk factor for stroke in women compared with men: a systematic review and meta-analysis of 81 cohorts,
including 3,980,359 individuals and 42,401 strokes. Stroke 2013;44:2821-2828.
Kim J, Gall SL, Dewey HM, et al. Baseline smoking status and the long-term risk of death or nonfatal vascular event in people with stroke: a 10-year
survival analysis. Stroke 2012;43:3173-3178.
Djousse L, Ellison RC, Beiser A, et al. Alcohol consumption and risk of ischemic stroke: The Framingham Study. Stroke 2002;33:907-912.
Mostofsky E, Burger MR, Schlaug G, et al. Alcohol and acute ischemic stroke onset: the stroke onset study. Stroke 2010;41:1845-1849.
Mohsenin V. Sleep-related breathing disorders and risk of stroke. Stroke 2001;32:1271-1278.
Jood K, Jern C, Wilhelmsen L, et al. Body mass index in mid-life is associated with a first stroke in men: a prospective population study over 28 years.
Stroke 2004;35:2764-2769.
Park JW, Lee SY, Kim SY, et al. BMI and stroke risk in Korean women. Obesity 2008;16:396-401.
Sandercock P, Bamford J, Dennis M, et al. Atrial fibrillation and stroke: prevalence in different types of stroke and influence on early and long term prognosis (Oxfordshire community stroke project). BMJ 1992;305:1460-1465.
Jorgensen HS, Nakayama H, Reith J, et al. Acute stroke with atrial fibrillation. The Copenhagen Stroke Study. Stroke 1996;27:1765-1769.
Lin HJ, Wolf PA, Kelly-Hayes M, et al. Stroke severity in atrial fibrillation. The Framingham Study. Stroke 1996;27:1760-1764.
Hornig CR, Bauer T, Simon C, et al. Hemorrhagic transformation in cardioembolic cerebral infarction. Stroke 1993;24:465-468.
Molina CA, Montaner J, Abilleira S, et al. Timing of spontaneous recanalization and risk of hemorrhagic transformation in acute cardioembolic stroke. Stroke
2001;32:1079-1084.
Dromerick A, Reding M. Medical and neurological complications during inpatient stroke rehabilitation. Stroke 1994;25:358-361.
Roth EJ, Lovell L, Harvey RL, et al. Incidence of and risk factors for medical complications during stroke rehabilitation. Stroke 2001;32:523-529.
Yoneda Y, Uehara T, Yamasaki H, et al. Hospital-based study of the care and cost of acute ischemic stroke in Japan. Stroke 2003;34:718-724.
ดาวน์โหลด
เผยแพร่แล้ว
2019-02-19
รูปแบบการอ้างอิง
1.
Na Songkhla K, Tantirittisak T, Hanchaiphiboolkul S, Wattanasen Y. Relationship between the ischemic stroke subtypes and risk factors included clinical outcome from Prasat Neurological Institute stroke registry. J Thai Stroke Soc [อินเทอร์เน็ต]. 19 กุมภาพันธ์ 2019 [อ้างถึง 31 ธันวาคม 2025];13(1-2):3-12. available at: https://he01.tci-thaijo.org/index.php/jtss/article/view/173157
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ประเภทบทความ
บทความวิจัย
สัญญาอนุญาต
ข้อความภายในบทความที่ตีพิมพ์ในวารสารสมาคมโรคหลอดเลือดสมองไทยเล่มนี้ ตลอดจนความรับผิดชอบด้านเนื้อหาและการตรวจร่างบทความเป็นของผู้นิพนธ์ ไม่เกี่ยวข้องกับกองบรรณาธิการแต่อย่างใด การนำเนื้อหา ข้อความหรือข้อคิดเห็นของบทความไปเผยแพร่ ต้องได้รับอนุญาตจากกองบรรณาธิการอย่างเป็นลายลักษณ์อักษร ผลงานที่ได้รับการตีพิมพ์ในวารสารเล่มนี้ถือเป็นลิขสิทธิ์ของวารสาร
