——美国梅奥诊所Alejandro A. Rabinstein教授专访
<International Circulation>:我的第一个问题是,对缺血性卒中预后有预测作用的卒中评分量表很多,您最近提出SPAN-100卒中评分,能介绍一下吗?
<International Circulation>: So it’s easy for lay-people and patients to understand it as well as people from different fields of medicine as well whether you are talking to different kinds and levels of care units. So it translates pretty easily across the field.
Rabinstein:Absolutely. This is something that can be easily understood by all sides of practitioners and those working in health care in general. It is also very intuitive and has a solid performance.
<International Circulation>:因此,普通人和患者,不同医学领域的人以及不同种类和水平的护理单位很容易理解。在各个领域都很容易被理解。
Rabinstein:当然是的。各个领域的实践者和在卫生保健单位工作的人都很容易理解。它非常直观,性能稳定。
<International Circulation>:In talking about pulmonary embolism (PE) and its relation to stroke, what are some of the clinical features, risk-factors and outcomes? Also, how exactly does it relate to stroke?
Rabinstein:PE is one of the most severe complications that can occur after a stroke. It more commonly happens after a hemorrhagic stroke rather than an acute ischemic stroke but it can happen after both and it can be fatal. The main risk factors for someone with PE in general is certainly immobility. This is why stroke patients have more PE than other patients in the hospital. In terms of clinical features, those of patients with stroke do not vary from the populations in the hospital or patients without stroke, except that the patient is very sick from the stroke. Some of the features may not be obvious immediately. For example, dyspnea may not be a complaint from a patient who is aphasic and cannot speak. But the objective manifestations namely tachycardia and hypoxia those are going to be present in certain patients as opposed to patients without stroke. And as to the outcome of patients with PE in patients with stroke, as opposed to patients with PE in patients without stroke, has not been well studied. There are large registry data that the occurrence of patients with PE without stroke certainly increases the risk of mortality.
<International Circulation>:在肺栓塞(PE)与卒中关系方面,其临床特征、危险因素和结局的情况是什么?PE是如何和卒中相关的?
Rabinstein:PE是卒中后发生的最严重的并发症之一,在出血性卒中后比在急性缺血性卒中后更为常见。在两者之后都能够发生,而且可以致命。PE的主要危险因素主要是肢体不运动。这就是卒中患者比其他住院患者更容易发生卒中的原因。临床特征方面,PE合并卒中的患者和医院其他患者或没有卒中的患者并没有什么差异,除了因卒中病情严重的患者。这些特征可能并不是一开始就很明显。例如失语的患者可能并不能诉呼吸困难。但是和没有卒中的患者相反,有些患者会出现心动过速和低氧血症等体征。关于卒中患者发生PE的结局。和没有卒中、发生PE的相比,并没有进行深入研究。但是有大型注册研究的数据确切表明没有卒中的患者发生PE能够增加死亡风险。