Department of Internal Medicine, BG Hospital Bergmannstrost Halle, Halle/Saale, Germany.
Practice for Internal Medicine and Vascular Diseases, Vein Competence Centre, Halle/Saale, Germany.
Vasa. 2022 Jan;51(1):46-55. doi: 10.1024/0301-1526/a000981. Epub 2021 Dec 2.
The main risk factors for cardiac events, and particularly for the development of atherosclerosis, are diabetes mellitus, arterial hypertension, dyslipidemia and smoking. Patients with a traumatic spinal cord injury (SCI) may present with autonomic nervous system dysfunction depending on their level of spinal cord injury. Studies have found a rise in cardiovascular mortality. A systematic review was conducted that focused on this patient group's predisposition to vascular risk. We performed a PubMed and Cochrane database search. After applying specific search criteria, 42 articles were included in our analysis out of a total of 10,784 matches. The articles were selected with the aim of establishing cardiovascular risk factors in patients with traumatic spinal cord injury. Patients with SCI are at an increased risk for peripheral artery disease even in the absence of cardiovascular risk factors. Major vascular changes to the arteries of patients with SCI include: a reduction in lumen size, increased vessel wall tension, higher vascular stiffness, an impaired reactive hyperemic response, and a lack of reduced vascular resistance. The findings for carotid atherosclerosis were inconclusive. This group of patients also has a higher disposition for diabetes mellitus, lipid metabolism disorders and coronary artery disease. Paraplegics are more likely to suffer from dyslipidemia, obesity and PAD, while tetraplegics are more likely to have diabetes mellitus. Patients with SCI are more likely to have cardiovascular risk factors and have cardiovascular disease compared to the normal population. Peripheral circulatory disorders are particularly common. Patients with SCI are now considered to be a new risk group for cardiovascular disease; however, large epidemiological studies are needed to verify in more detail the cardiovascular risk profile of this patient group.
心脏事件的主要危险因素，特别是动脉粥样硬化的发展，包括糖尿病、动脉高血压、血脂异常和吸烟。外伤性脊髓损伤（SCI）患者可能会出现自主神经系统功能障碍，具体取决于其脊髓损伤的程度。研究发现心血管死亡率上升。我们进行了一项系统评价，重点关注该患者群体的血管风险倾向。我们在 PubMed 和 Cochrane 数据库中进行了搜索。在应用特定的搜索标准后，从总共 10784 个匹配项中，有 42 篇文章被纳入我们的分析。选择这些文章的目的是确定外伤性脊髓损伤患者的心血管危险因素。即使没有心血管危险因素，SCI 患者也有发生外周动脉疾病的风险。SCI 患者的动脉主要血管变化包括：管腔缩小、血管壁张力增加、血管僵硬增加、反应性充血反应受损以及血管阻力降低。颈动脉粥样硬化的研究结果尚无定论。这组患者也更容易患糖尿病、脂代谢紊乱和冠心病。截瘫患者更容易发生血脂异常、肥胖和 PAD，而四肢瘫痪患者更容易患糖尿病。与正常人群相比，SCI 患者更有可能存在心血管危险因素和心血管疾病。周围循环障碍尤其常见。SCI 患者现在被认为是心血管疾病的一个新的危险群体；然而，需要进行大规模的流行病学研究，以更详细地验证该患者群体的心血管风险特征。
