Leon H. Charney Division of Cardiology, New York University Langone Medical Center, New York, New York 10016, USA.
Curr Opin Cardiol. 2011 Nov;26(6):472-9. doi: 10.1097/HCO.0b013e32834b7fdd.
To describe cholesterol embolization syndrome (CES) and its risk factors, pathophysiology, clinical presentation, diagnosis and treatment.
To date, no specific diagnostic test (other than biopsy) for CES has been developed. Effective treatments for CES are yet to be developed.
CES (also referred to as cholesterol crystal embolization, atheromatous embolization or atheroembolism) occurs when cholesterol crystals and other contents of an atherosclerotic plaque embolize from a large proximal artery to smaller distal arteries, causing ischemic end-organ damage. Clinical manifestations of CES include constitutional symptoms (fever, anorexia, weight loss, fatigue and myalgias), signs of systemic inflammation (anemia, thrombocytopenia leukocytosis, high erythrocyte sedimentation rate, elevated levels of C-reactive protein, hypocomplementemia), hypereosinophilia, eosinophiluria, acute onset of diffuse neurologic deficit, amaurosis fugax, acute renal failure, gut ischemia, livedo reticularis and blue-toe syndrome. CES may occur spontaneously or after an arterial procedure. There is no specific laboratory test for CES. Retinal exam demonstrating Hollenhorst plaques supports the diagnosis of CES. Biopsy of target organs (usually skin, skeletal muscles or kidneys) is the only means of confirming the diagnosis of CES. Treatment consists of supportive care and general management of atherosclerosis and arterial ischemia.
描述胆固醇栓塞综合征（CES）及其危险因素、病理生理学、临床表现、诊断和治疗。
迄今为止，尚未开发出用于 CES 的特定诊断测试（活检除外）。有效的 CES 治疗方法仍有待开发。
CES（也称为胆固醇晶体栓塞、粥样斑块栓塞或动脉粥样栓塞）是指胆固醇晶体和粥样斑块的其他内容物从大的近端动脉栓塞到较小的远端动脉，导致缺血性终末器官损伤。CES 的临床表现包括全身症状（发热、厌食、体重减轻、疲劳和肌痛）、全身炎症迹象（贫血、血小板减少、白细胞增多、红细胞沉降率升高、C 反应蛋白水平升高、补体缺乏）、嗜酸性粒细胞增多、嗜酸性粒细胞尿、弥漫性神经功能缺损的急性发作、一过性黑矇、急性肾衰竭、肠道缺血、网状青斑和蓝趾综合征。CES 可自发发生或在动脉手术后发生。目前没有针对 CES 的特定实验室检测。视网膜检查显示 Hollenhorst 斑块支持 CES 的诊断。对目标器官（通常是皮肤、骨骼肌或肾脏）进行活检是确诊 CES 的唯一方法。治疗包括支持性护理和动脉粥样硬化及动脉缺血的一般管理。
