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经食管超声心动图对胆固醇栓塞中胸主动脉的研究。

Investigation of the thoracic aorta in cholesterol embolism by transoesophageal echocardiography.

作者信息

Ferrari E, Taillan B, Drai E, Morand P, Baudouy M

机构信息

Department of Cardiology, Hôpital Pasteur, Nice, France.

出版信息

Heart. 1998 Feb;79(2):133-6. doi: 10.1136/hrt.79.2.133.

DOI:10.1136/hrt.79.2.133
PMID:9538304
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC1728595/
Abstract

OBJECTIVES

To examine the thoracic aorta of patients with severe cholesterol embolism (CE) by transoesophageal echocardiography (TOE).

METHODS

The thoracic aorta of 20 consecutive patients with CE was compared with that in a control population matched for age and risk factors by TOE. Patients were prescribed steroids after CE was diagnosed. Follow up is reported and compared with results in the literature.

RESULTS

Aortic plaques and debris were more common in patients with CE than in the control population (p < 0.001 and p < 0.0001, respectively). The mean (SD) number of aortic plaques in the CE patients was 2.6 (0.7). This aortic atheroma was found predominantly in the descending aorta. One patient died during a mean (SD) follow up of 24 (10) months.

CONCLUSIONS

Aortic atheroma, as detected by TOE, should be considered as the main source of CE. In addition, the prognosis in our series, in which steroids were systemically prescribed, is much better than in others reported in the literature.

摘要

目的

通过经食管超声心动图(TOE)检查严重胆固醇栓塞(CE)患者的胸主动脉。

方法

通过TOE将20例连续的CE患者的胸主动脉与年龄和危险因素相匹配的对照人群的胸主动脉进行比较。CE诊断后给患者使用类固醇。报告随访情况并与文献中的结果进行比较。

结果

CE患者的主动脉斑块和碎片比对照人群更常见(分别为p < 0.001和p < 0.0001)。CE患者主动脉斑块的平均(标准差)数为2.6(0.7)。这种主动脉粥样硬化主要见于降主动脉。在平均(标准差)24(10)个月的随访期间有1例患者死亡。

结论

TOE检测到的主动脉粥样硬化应被视为CE的主要来源。此外,在我们系统性使用类固醇的系列研究中,预后比文献中报道的其他研究要好得多。

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本文引用的文献

1
Atheromatous emboli to the kidneys after aortic surgery.主动脉手术后肾脏的动脉粥样硬化栓子。
N Engl J Med. 1957 Sep 5;257(10):442-7. doi: 10.1056/NEJM195709052571002.
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Aortic atherosclerotic plaques as a source of systemic embolism.主动脉粥样硬化斑块作为全身栓塞的一个来源。
J Am Coll Cardiol. 1996 Mar 1;27(3):664-9. doi: 10.1016/0735-1097(95)00526-9.
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Natural history of severe atheromatous disease of the thoracic aorta: a transesophageal echocardiographic study.胸主动脉严重动脉粥样硬化疾病的自然史:一项经食管超声心动图研究。
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Blue digit syndrome: transesophageal echocardiographic identification of thoracic aortic plaque-related thrombi and successful outcome with warfarin.蓝色指综合征:经食管超声心动图对胸主动脉斑块相关血栓的识别及华法林治疗的成功结果
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Cholesterol embolization syndrome. Occurrence after intravenous streptokinase therapy for myocardial infarction.胆固醇栓塞综合征。发生于心肌梗死静脉注射链激酶治疗后。
JAMA. 1987 Oct 9;258(14):1934-5. doi: 10.1001/jama.258.14.1934.
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Cholesterol crystal embolization: a review of 221 cases in the English literature.胆固醇结晶栓塞:英文文献中221例病例综述
Angiology. 1987 Oct;38(10):769-84. doi: 10.1177/000331978703801007.
10
Cholesterol emboli after cardiac catheterization. Eight cases and a review of the literature.心脏导管插入术后的胆固醇栓子。八例病例及文献综述。
Medicine (Baltimore). 1988 Nov;67(6):389-400. doi: 10.1097/00005792-198811000-00003.