心脑梗死  

Cardio-cerebral infarction

作　　者：杨文武 闵晓黎[1] 林嗣弦 先磊 Yang Wenwu;Min Xiaoli;Lin Sixian;Xian Lei(Department of Cerebrovascular Diseases,the Second Affiliated Hospital of Kunming Medical University,Kunming 650101,China)

机构地区：[1]昆明医科大学第二附属医院脑血管病科,昆明650101

出　　处：《国际脑血管病杂志》2023年第10期762-767,共6页International Journal of Cerebrovascular Diseases

基　　金：云南省科技重点研发计划(202203AC100007)。

摘　　要：急性心肌梗死(acute myocardial infarction, AMI)和急性缺血性卒中(acute ischemic stroke, AIS)是导致全世界人口死亡和残疾的主要原因。心脑梗死(cardio-cerebral infarction, CCI)是AMI合并AIS的罕见临床综合征, 是指同时存在急性局灶性神经功能缺损和心前区疼痛或心电图改变的危急症状。CCI的患病率从0.09%至1.6%不等, 但患者病情危急, 预后较差, 病死率和致残率居高不下。由于病情复杂、病因多样以及循证证据和机制研究较少, 针对CCI患者的管理具有挑战性。文章总结了CCI的相关发病机制、药物治疗的效果、血管内治疗的指征以及手术顺序的选择, 期望可缩短溶栓/血管内治疗时间, 并改善患者转归。Acute myocardial infarction(AMI)and acute ischemic stroke(AIS)are leading causes of death and disability in the world population.Cardio-cerebral infarction(CCI)is a rare clinical syndrome of AMI combined with AIS,which refers to the critical symptoms of simultaneous acute focal neurological deficits and precordial pain or electrocardiogram changes.The incidence of CCI ranges from 0.09%to 1.6%,but patients have a critical condition,poor prognosis,and high mortality and disability rates.Due to the complexity of the condition,diverse etiology,and limited evidence and mechanistic research,the management of patients with CCI is challenging.This article summarizes the pathogenesis related to CCI,the effectiveness of drug treatment,indications for endovascular treatment,and the selection of surgical sequence,with the aim of shortening thrombolysis/endovascular treatment time and improving outcomes of patients.

关 键 词：缺血性卒中 心肌梗死 血栓溶解疗法 血管内手术 血栓切除术 抗凝药 抗血小板聚集药 治疗结果 

分 类 号：R542.22[医药卫生—心血管疾病] R743.33[医药卫生—内科学]