10.3969/j.issn.1008-0678.2000.z1.077
Mixed Stroke
Purpose To summarize the chnical, autoptic and animal experimental dala of stroke, propose the concept of mixed stroke (MS) and demonstrate the enoiogy, pathogenesis, clinical mainfestations, prophylaxis and treatment of MS Background At present. stroke still is classified in the national and international academic fields as two main groups: hemorrhage and ischema In fact, thc cerebral vascular disease with hemorrhage forus and ischema focus at the same time is not rare moreover, this type of stroke has special etiology, pathogenesis and clinical manifestations. But it is always made a main dagnosis and neglected the other nature of coexistent focus on either clinical or pathological diagnosis according to traditional classification of stroke Data sources and methods Mort of pablished originsl articles about MS in our department and laboralory wcre reviewed. Resulta The clinical autoptic and animal experimental dats all prcved that hemorrhage and infarction could occur in the course of a stroke simultaneously or in suecession during a short time, which demonstrated the existence of MS It was found clinically that MS patients all had the hustory of hypcrtension and in the autoptic data the MS patients dying of stroke all had typical hypertensive changes in the heart and kidney. and had hypertensive arteriosclerosis in the cerebral arteriole and small artery. MS was cas lily thdueed in stroke-prone renovascular hypertensivc rats This kind of rats are free from genetic deficiency and arc not affected by senile factor, so their cerebral vascular foci are mainly induced by the single factor -hypertension. TThese indicate definitely that hypertensive cerebral vascular lesion is the basis inducing MS. The main lesions of hypertensive cerebral arteriole and small artery were hyalinosis and fibrinoid of the walls, and the formation of microaneurysms or hyperplasla of iniernal and external layers The math lcsions of hypertensive cerebral capillaries were increasing vascular permeability. mural damage. edema of brain tissuc surroumding the vessel. stenotie lumen and leakage of bloed cells These lcsions in varying degrees were observed at different part of thc same brain or at different length of the same vessel at the same time, on the basis of which both hemocrhagic stroke and ischemic stroke could occurr These indicate the brain of the same patient with hypertension has pathomocpliological base of hemorrhagic strokc and ischemic stroke at the same time After after acute cerebral vascular disease occurring, it can be complicated by the other opposite nature of focus during a short time owing to oppression. draw. vascular spasm, metabolic disotder. sharp fluctuation of systemic blood pressure and other factors. The MS patients often had alterations of consciousness and the sign5 of meningeal irritation. were easlily complicated by multiple system organ failure Few cascs had distinct mulufocal cerebral lesions climcally. but after a careful cxamination of the nervous system. bilateral pathologic reflexes were often found. CT or MRI is an important means to diagnose Mis and should be used in 1 -Sd after the onset The measures of treatment for MS should be more vigorous and reliable The factors aggravating pathological lesion should be paid special attention to prevent When MS suspected of occurring clinically, rational neutral measures of treatment are advisable With MS definitely diagnosed the doctors should treat the main foous positively. keep homeostasis, prevent the disorder of hypothafamic function. select proper drugs and treat mfection positively Preventing multiple system organ failure is a key to decrease the mortality of MS. Having spent many years exploring, we establish the anunal model of coexistent infarction and hemorrhage on the basis of stroke-prone renovascular hypertensive rats The incidence of MS up to 95% was found in the group. which were given an inIection of fiblinogen and resperpine. As this model can stimulate the clinical evolution of stroke very well and has very high incidence. it Is a good animal model of MS. conclusions It is essential to list MS as a type of stroke singly. Valuing and studying MS are im ponant for the whole fieid studying pathogenesis. prophylaxis and treatment of stoke.
multiple system organ failure、vascular disease、renovascular hypertensive rats、ischemic stroke、systemic blood pressure、pathological diagnosis、measures of、vascular permeability、nature of、vascular lesion、type of、nervous system、animal model、used in
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R74;R24
2005-07-07(万方平台首次上网日期,不代表论文的发表时间)
共1页
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