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库欣综合征中的高凝状态:从动脉到静脉疾病。

Hypercoagulability in Cushing's syndrome: From arterial to venous disease.

机构信息

Division of Endocrinology, Department of Medicine, Centre intégré universitaire de santé et de services sociaux de l'Estrie - Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Québec, Canada.

Department of Endocrinology, Singapore General Hospital, Singapore.

出版信息

Best Pract Res Clin Endocrinol Metab. 2021 Mar;35(2):101496. doi: 10.1016/j.beem.2021.101496. Epub 2021 Feb 13.

Abstract

Cushing's syndrome (CS) is associated with multisystemic complications; the hematological system is not spared. Alteration in hemostatic parameters and in vivo endothelial dysfunction lead to increased thrombotic events. Arterial and venous thrombotic events carry significant morbidity and mortality. Death from cardiovascular and pulmonary embolism account for more than 50% of mortality. Surgery is a critical period; close to 50% of events occur in the 1-2 months after intervention. The evaluation and risk stratification of patients with CS is key to prevent events, balancing the risk-benefit of anticoagulation in this population. This current review will focus on up-to-date data on epidemiology, pathophysiology and management of hypercoagulability in CS.

摘要

库欣综合征(CS)与多系统并发症相关;血液系统也不能幸免。止血参数的改变和体内内皮功能障碍导致血栓形成事件增加。动脉和静脉血栓形成事件具有显著的发病率和死亡率。心血管和肺栓塞导致的死亡占总死亡率的 50%以上。手术是一个关键时期;近 50%的事件发生在干预后 1-2 个月内。评估和风险分层 CS 患者是预防事件的关键,需要权衡该人群抗凝治疗的风险效益。本综述将重点介绍 CS 高凝状态的最新流行病学、病理生理学和管理数据。

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