摘要
颅内动脉粥样硬化性狭窄(ICAS)是缺血性卒中和短暂性脑缺血发作(TIA)的重要病因,亦可引起认知障碍和痴呆。总体而言,亚洲ICAS患病率显著高于西方国家。近年来,关于ICAS的流行病学、诊断、评估、预后和治疗方面出现了很多新的证据,国外亦有相关指南或共识发布。为了更好地指导我国各级医疗机构进行ICAS的筛查、诊断和治疗工作,中国研究型医院学会、中国医师协会神经介入专业委员会以及中国神经科学学会脑血管功能与疾病分会成立专家组,制订《颅内动脉粥样硬化性狭窄诊治指南(2025版)》。本指南依据已发表的临床研究证据并结合国内外相关指南或专家共识,拟进一步明确ICAS的相关定义、流行病学特征、预后情况及高危人群特征,并基于现有证据就相关筛查、诊断、评估及治疗方法和策略提出30条推荐意见,旨在提高相关临床和科研人员对ICAS的重视和认知、促进对相关患者的规范化治疗,以期最终降低ICAS的患病率及相关的卒中、认知障碍和其他临床事件风险,改善患者的预后。
Intracranial atherosclerotic stenosis(ICAS)is an important cause of ischemic stroke and transient ischemic attack(TIA),which can also lead to cognitive impairment and dementia.Overall,the prevalence of ICAS is significantly higher in Asian than in Western countries/regions.In recent years,new evidence has emerged regarding the epidemiology,diagnosis,assessment,prognosis and treatment of ICAS,hence there have been guidelines or consensus statements published on the topic in other countries/regions.To better guide the screening,diagnosis and treatment of ICAS in China,the Chinese Research Hospital Association,the Neurointerventional Professional Committee of Chinese Medical Doctor Association,and the Branch of Cerebrovascular Function&Disease convened an expert panel to develop the'Guidelines for Diagnosis and Treatment of Intracranial Atherosclerotic Stenosis(2025 edition).The guidelines are developed based on published research evidence and in reference to relevant domestic and international guidelines or expert consensus,aiming to further clarify the definition,epidemiology and prognosis of ICAS and profiles of high-risk ICAS patients,and provide 30 recommendations on screening,diagnosis,assessment and treatment strategies based on current evidence.We also aim to enhance awareness and understanding of ICAS among clinical and research professionals,promote standardized patient management,and ultimately reduce the prevalence of ICAS and the subsequent risks of stroke,cognitive impairment and other clinical events,thereby improving patient outcomes.
作者
中国研究型医院学会
中国医师协会神经介入专业委员会
中国神经科学学会脑血管功能与疾病分会
徐蔚海
焦力群
冷昕祎
隋滨滨
刘彩燕
王韬
The Chinese Research Hospital Association;The Neurointerventional Professional Committee of ChineseMedical Doctor Association;The Branch of Cerebrovascular Function&Disease of the ChineseNeuroscience Society;Xu Weihai;Jiao Liqun(不详;Department of Neurology,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences,Beijing 100730,China;Department of Interventional Radiology/Neurosurgery,Xuanwu Hospital,Capital Medical University,Beiing 100053,China)
出处
《中华医学杂志》
北大核心
2025年第29期2449-2468,共20页
National Medical Journal of China
基金
癌症、心脑血管、呼吸和代谢性疾病防治研究国家科技重大专项(2024ZD0521600)
国家杰出青年科学基金(82025013)
北京市自然科学基金(L232130)
香港特别行政区政府医务卫生局医疗卫生研究基金(10210366)
中央高水平医院临床科研专项基金(2022-PUMCH-C-001、2022-PUMCH-D-007)。
