中国卒中杂志 ›› 2019, Vol. 14 ›› Issue (05): 463-467.DOI: 10.3969/j.issn.1673-5765.2019.05.011

• 专题综述 • 上一篇    下一篇

非细菌性血栓性心内膜炎与卒中

唐煜,黄光   

  1. 100038 北京首都医科大学附属复兴医院神经内科
  • 收稿日期:2019-02-22 出版日期:2019-05-20 发布日期:2019-05-20
  • 通讯作者: 黄光 hsmmt@sina.com

Nonbacterial Thromboendocarditis and Stroke

  • Received:2019-02-22 Online:2019-05-20 Published:2019-05-20

摘要:

非细菌性血栓性心内膜炎(nonbacterial thromboendocarditis,NBTE)是一种异质性疾病,以 心脏瓣膜赘生物形成为特征。NBTE与恶性肿瘤及其他原因所致的高凝状态有关,是引起隐匿性卒中 的原因之一。经食道超声心动图和头颅MRI是诊断NBTE相关卒中的重要方法。合并恶性肿瘤的NBTE 患者发生卒中的风险较正常人群高,短期内卒中的复发率高、预后差。因此,早期识别NBTE相关性卒 中,并开展相应的治疗和二级预防是值得临床关注的问题。目前对NBTE的治疗包括原发肿瘤的治疗 和抗凝治疗两部分。

文章导读: 细菌性血栓性心内膜炎虽然发病率很低,但其卒中风险较高,且可能导致全身多器官栓塞,本文对其相关性卒中的临床特点和治疗进行了总结。

关键词: 非细菌性心内膜炎; 赘生物; 栓塞; 卒中; 肿瘤

Abstract:

Nonbacterial thromboendocarditis (NBTE) is a heterogeneous disease characterized by the formation of valve vegetations. NBTE is associated with malignancy and hypercoagulability caused by various causes, and is one of the causes of cryptogenic stroke. Transesophageal echocardiography and MRI are important examination methods to diagnose NBTE-related stroke. NBTE patients with malignant tumor have a higher risk of stroke than general population, and the recurrence rate of stroke in the short term is high and the prognosis is poor. Therefore, early identification of NBTE-related stroke, timely secondary prevention and treatment are necessary and important. Treatment of NBTE includes tumor therapy and anticoagulation therapy.

Key words: Nonbacterial thrombotic endocarditis; Vegetations; Embolism; Stroke; Tumor