感染性心内膜炎相关脑血管并发症及其抗凝治疗策略  

Cerebrovascular complications associated with infective endocarditis and anticoagulant treatment strategies

作　　者：肖开提江·木合塔尔 赵丰 XIAOKAITIJIANG·Muhetaer;ZHAO Feng(Grade 2021 of Clinical College,Graduated School,Tianjin Medical University,Tianjin 300070,China;Department of Cardiovascular Surgery,Tianjin Institute of Cardiovascular Disease,Tianjin Key Laboratory of Cardiovascular Emergency and Critical Care,Chest Hospital,Tianjin University,Tianjin 300222,China)

机构地区：[1]天津医科大学研究生院临床医学系,300070 [2]天津大学胸科医院心血管外科,天津市心血管病研究所,天津市心血管急危重症重点实验室,300222

出　　处：《中国现代神经疾病杂志》2024年第2期91-96,共6页Chinese Journal of Contemporary Neurology and Neurosurgery

基　　金：天津市医学重点学科(专科)建设项目(项目编号:TJYXZDXK-042A);天津市科技计划项目(项目编号:22JCYBJC01440);天津市卫生健康科技项目(项目编号:TJWJ2023ZD006)。

摘　　要：感染性心内膜炎常导致各种血管并发症,其中脑血管并发症与疾病早期和晚期病死率增加有关。感染性心内膜炎抗凝治疗目前仍存争议,治疗过程中如何平衡脑栓塞与出血事件的风险是目前临床难以界定的难题。本文从感染性心内膜炎相关脑栓塞与出血事件的流行病学、病理生理学、影像学评估手段及抗凝治疗策略等方面进行阐述,以为疾病的抗凝治疗提供指导。Infective endocarditis often leads to various vascular complications,among which cerebrovascular complications are associated with increased mortality in the early and late stages of the disease.Anticoagulant therapy for infective endocarditis is still controversial.How to balance the risk of cerebral embolism and bleeding events during the treatment is a difficult problem to define in clinical practice.This article reviews the epidemiology,pathophysiology,imaging evaluation methods and anticoagulation treatment strategies of disease⁃related cerebral embolism and bleeding events,in order to provide guidance for clinical anticoagulant treatment of infective endocarditis.

关 键 词：心内膜炎 脑血管障碍 抗凝药 综述 

分 类 号：R542.41[医药卫生—心血管疾病] R743[医药卫生—内科学]