Chomette G, Auriol M, Baubion D, de Frejacques C
Ann Med Interne (Paris). 1980;131(7):443-7.
During the course of 6 000 autopsies, the number of cases of non-bacterial thrombotic endocarditis discovered was 130 (absolute frequency of 2.1 p. cent). Frequency was highest among patients with cancer, of which there were many in this series (4 p. cent of 2 287 autopsies). In 83 p. cent of cases, therefore, the endocarditis was of paraneoplasic origin, usually associated with adenocarcinomas, especially those of bronchopulmonary, pancreatic or gastric origin. Less frequently, they developed during the course of shock or debilitating affections. The endocarditis lesion consists of a coagulated fibrin and platelet mass without microbial germs, located electively on the mitral and aortal valves. Emboli are a frequent consequence (47 p. cent of cases) affecting primarily the central nervous system, the kidneys, spleen, and hart. Ischemic effects of these latter, observed in 75 p. cent of cases, are generally latent. In some cases they produce clinical manifestations, and they may be the cause of death from a cerebral or myocardial infarct. Pathological examination demonstrates the frequent association of these endocarditis lesions with often multiple vascular thromboses, and disseminated intravascular coagulation affecting the same regions as the emboli. This emphasizes the major role of coagulation disorders in their genesis.
在6000例尸检过程中，发现非细菌性血栓性心内膜炎病例130例（绝对频率为2.1%）。在癌症患者中频率最高，本系列中有许多癌症患者（2287例尸检中的4%）。因此，在83%的病例中，心内膜炎是副肿瘤性起源，通常与腺癌相关，尤其是支气管肺、胰腺或胃起源的腺癌。较少见的情况是，它们在休克或衰弱性疾病过程中发生。心内膜炎病变由无微生物的凝固纤维蛋白和血小板团块组成，选择性地位于二尖瓣和主动脉瓣上。栓塞是常见后果（47%的病例），主要影响中枢神经系统、肾脏、脾脏和心脏。在75%的病例中观察到的这些器官的缺血效应通常是潜伏性的。在某些情况下，它们会产生临床表现，并且可能是脑梗死或心肌梗死死亡的原因。病理检查表明，这些心内膜炎病变常与多处血管血栓形成以及与栓塞相同区域的弥散性血管内凝血频繁相关。这强调了凝血障碍在其发生过程中的主要作用。
