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首页> 外文期刊>Journal of neurology >Prevalence and prognostic impact of microembolic signals in arterial sources of embolism. A systematic review of the literature.
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Prevalence and prognostic impact of microembolic signals in arterial sources of embolism. A systematic review of the literature.

机译：栓塞的动脉源中微栓塞信号的发生率和预后影响。对文献的系统回顾。

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OBJECTIVE: To compile available studies using microembolic signal (MES) detection by transcranial Doppler sonography in varying sources of arterial brain embolism. We investigated prevalences of MES and whether MES detection is of proven use for risk stratification. METHOD: Studies reporting prevalences of MES and the risk of cerebral ischemic events were pooled for patients with symptomatic or asymptomatic carotid stenosis, intracranial artery stenosis, cervical artery dissection, and aortic embolism. RESULTS: MES were reported in 43% of 586 patients with symptomatic and in 10% of 1066 patients with asymptomatic carotid stenosis. Presence of one MES indicated an increased risk of future events [odds ratio (OR): 7.5, 95% confidence interval (CI): 3.6-15.4, p<0.0001 for symptomatic, and OR: 13.4, 95% CI: 6.5-27.4, p<0.0001 for asymptomatic disease). MES were reported in 25% of 220 patients with symptomatic vs. 0% of 86 patients with asymptomatic intracranial stenosis (p<0.0001), Of 82 patients with cervical artery dissection presenting with TIA or stroke, 50% had MES compared with 13% of 16 patients with local symptoms (p=0.006), In patients with aortic embolism, patients with plaques >or= 4 mm more frequently had MES compared with patients with smaller plaques (p=0.04), Data were insufficient to reliably predict future events in patients with intracranial stenosis, cervical artery dissection, and aortic embolism. CONCLUSION: MES are a frequent finding in varying sources of arterial brain embolism, MES detection is useful for risk stratification in patients with carotid stenosis.
机译：目的：利用经颅多普勒超声检查微栓塞信号（MES）检测在各种动脉栓塞来源中进行的现有研究。我们调查了MES的患病率以及MES检测是否可用于风险分层。方法：对有症状或无症状的颈动脉狭窄，颅内动脉狭窄，颈动脉夹层和主动脉栓塞的患者，汇总报告MES患病率和脑缺血事件风险的研究。结果：在586例有症状的患者中有43％报道了MES，在1066例无症状的颈动脉狭窄中有10％报道了MES。一种MES的存在表明未来事件的风险增加[几率（OR）：7.5，95％置信区间（CI）：3.6-15.4，有症状的p <0.0001，OR：13.4，95％CI：6.5-27.4 ，对于无症状疾病，p <0.0001）。在220例有症状的患者中有25％报道了MES，而在86例无症状性颅内狭窄患者中则为0％（p <0.0001）。在有TIA或中风的82例颈动脉夹层患者中，有MES的占50％，而在有TIA或卒中的情况下有MES 16例具有局部症状的患者（p = 0.006），与较小斑块的患者相比（p = 0.04），在主动脉栓塞患者中，斑块大于或等于4mm的患者发生MES的频率更高（p = 0.04），数据不足以可靠地预测未来的事件颅内狭窄，颈动脉夹层和主动脉栓塞的患者。结论：MES是动脉脑栓塞的各种来源中的常见发现，MES检测对于颈动脉狭窄患者的危险分层很有用。

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