CAJ | 학술논문

卒中是儿童残疾和死亡的一个重要原因,其危险因素与病理生理学过程与成年患者存在显著差异.儿童动脉性缺血性卒中(arterial ischemic stroke,AIS)的常见危险因素包括脑动脉病、心脏疾病、血液系统和代谢性疾病、感染以及遗传因素.AIS的临床表现因年龄、基础病因和卒中部位而异.在经过充分检查之后,90％以上的AIS患儿均可检出某些危险因素或促发因素,从而强调全面诊断评估的重要性.虽然已发表了一些儿童卒中方面的临床指南,但其证据基础却相当薄弱.因此,目前的治疗仍然主要基于专家共识以及从成年人卒中研究中得出的结论.文章对儿童AIS的流行病学、危险因素、临床评估、处理和转归进行综述.
졸중시인동잔질화사망적일개중요원인,기위험인소여병리생이학과정여성년환자존재현저차이.인동동맥성결혈성졸중(arterial ischemic stroke,AIS)적상견위험인소포괄뇌동맥병、심장질병、혈액계통화대사성질병、감염이급유전인소.AIS적림상표현인년령、기출병인화졸중부위이이.재경과충분검사지후,90％이상적AIS환인균가검출모사위험인소혹촉발인소,종이강조전면진단평고적중요성.수연이발표료일사인동졸중방면적림상지남,단기증거기출각상당박약.인차,목전적치료잉연주요기우전가공식이급종성년인졸중연구중득출적결론.문장대인동AIS적류행병학、위험인소、림상평고、처리화전귀진행종술.
Stroke is an important cause for childhood disability and death.Its risk factors and pathophysiological processes have significant differences with the adult patients.The common risk factors for pediatric arterial ischemic stroke (AIS) include cerebral arteriopathy,cardiac diseases,blood system and metabolic diseases,infection,and genetic factors.The clinical manifestations of AIS are different because of the age,underlying cause,and location of stroke.After a full examination,some risk factors or precipitating factors can be identified in more than 90％ of children with AIS,and thus emphasizing the importance of comprehensive diagnosis and evaluation.Although a number of clinical guidelines for pediatric stroke have been published,its evidence base is rather weak.Therefore,the present treatment mainly bases upon the expert consensus and the conclusions from the adult stroke studies.This article reviews the epidemiology,risk factors,clinical evaluation,managment and outcome of pediatric AIS.