感染性心内膜炎继发高滴度抗磷脂抗体阳性1例  

A case of high level of elevated antiphospholipid antibodies positive secondary to infective endocarditis

作　　者：李林光 肖敏 蔡松 Li Linguang;Xiao Min;Cai Song(Department of Cardiology,Beijing Longfu Hospital,Beijing 100010,China)

机构地区：[1]北京市隆福医院心血管内科,北京100010

出　　处：《中国综合临床》2022年第4期366-368,共3页Clinical Medicine of China

摘　　要：感染性心内膜炎(infective endocarditis,IE)导致的一过性抗磷脂抗体高滴度阳性的病例少见。现报道1例因发热就诊的IE的青年女性合并有两处肢体动脉栓塞,行抗磷脂抗体检查IgM型呈高滴度阳性,既往曾行二尖瓣生物瓣膜置换术,超声提示二尖瓣生物瓣膜置换术后IE,考虑人工瓣膜IE,多次血培养检查阴性,给予经验性抗感染及二次开胸二尖瓣置换术治疗,术后抗感染、华法林抗凝等治疗,病情稳定,一处肢体动脉血管再通,3个月后复查抗磷脂抗体转为阴性。该病例的诊治提示IE可继发一过性的高滴度的抗磷脂抗体阳性,临床中如早期发现早期应用抗凝药物治疗是否会减少血栓栓塞的发生需要引起临床医师的关注。It is quiet rare that transient high level of elevated antiphospholipid(aLP)antibodies are triggered by infective endocarditis(IE).We report a young woman who went to hospital because of fever was diagnosed with IE,she was suffering from lower and upper arterial thrombosis,tests showed that anticardiolipin and anti-beta2-glycoprotein(GP)-1 IgM antibodies elevated highly.She had mitral valve replacement surgery,echocardiography detected vegetation on mitral valve,multiple blood culture showed negative,after treatment of antibiotics,the second cardiac surgery and warfarin,the patient got stable condition and the upper limb arterial thrombosis disappeared.Three months later,aLP antibodies tests came back negative.This case illustrate that IE could lead to transient high level of elevated aLP antibodies,does that increase the risk of thrombosis of IE patient is unknown,what if we find that phenomenon earlier and prescribe anticoagulant drugs,that need more observation.

关 键 词：感染性心内膜炎 抗磷脂抗体 血栓形成 

分 类 号：R542.41[医药卫生—心血管疾病]