Department of Neurosurgery, School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, New York; Department of Neurosurgery, Millard Fillmore Gates Hospital, Kaleida Health, Buffalo, New York.
Department of Neurosurgery, School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, New York; Department of Neurosurgery, Millard Fillmore Gates Hospital, Kaleida Health, Buffalo, New York.
J Stroke Cerebrovasc Dis. 2011 Jan-Feb;20(1):1-9. doi: 10.1016/j.jstrokecerebrovasdis.2009.09.011. Epub 2010 Jun 9.
We present an overview of multiple infections in relation to acute ischemic stroke and the therapeutic options available. Conditions that are a direct cause of stroke (infectious endocarditis, meningoencephalitides, and human immunodeficiency virus infection), the pathophysiologic mechanism responsible for stroke, and treatment dilemmas are presented. Independently or in conjunction with conventional risk factors, chronic and acute infections can trigger an acute ischemic stroke through an accelerated process of atherosclerosis and immunohematologic alterations. Acute ischemic stroke has a negative impact on the antibacterial immune response, leading to stroke-induced immunodepression and infections, the most common poststroke medical complications. Poststroke infections are independent predictors of poor outcome. Antibiotic trials for poststroke infection prevention are reviewed. Although antibiotic prophylaxis is not the standard of care in acute stroke, current guidelines support prompt treatment of stroke-related infections.
我们介绍了与急性缺血性中风相关的多种感染及其可用的治疗选择。本文介绍了中风的直接病因（感染性心内膜炎、脑膜脑炎和人类免疫缺陷病毒感染）、导致中风的病理生理机制以及治疗难题。慢性和急性感染可通过加速动脉粥样硬化和免疫血液学改变的过程引发急性缺血性中风，这些感染可独立或与传统危险因素一起引发急性缺血性中风。急性缺血性中风对抗菌免疫反应产生负面影响，导致中风引起的免疫抑制和感染，这是中风后最常见的医疗并发症。中风后感染是预后不良的独立预测因素。本文还回顾了预防中风后感染的抗生素试验。尽管抗生素预防不是急性中风的标准治疗方法，但目前的指南支持及时治疗与中风相关的感染。
