感染與心血管疾病

1、感染與心血管疾病,一、文獻(xiàn)來(lái)源二、內(nèi)容簡(jiǎn)介三、分析與討論四、結(jié)論與啟示,一、文獻(xiàn)來(lái)源,1. Role of acute infection in triggering acute coronary syndromes. Lancet Infect Dis 2010; 10: 83–922.Influenza and Cardiovascular Disease：Is There a Causal Relationship? T

2、ex Heart Inst J. 2004; 31(1): 4–13.3. Immunosuppressive Treatment for Inflammatory Cardiomyopathy. Int Heart J 2005; 46: 113-1224. Guidelines on the prevention, diagnosis, and treatment of infective endocardi

3、tis (new version 2009). European Heart Journal (2009) 30, 2369–2413. 5. Efficacy of daptomycin in the treatment of enterococcal endocarditis: a 5 year comparison with conventional therapy. J Antimicrob Chemother. 2

4、014 Feb 13, PMID: 24532682,,1、感染（infection）系指由細(xì)菌、病毒、真菌、衣原體、支原體、立克次體、螺旋體、原蟲、蠕蟲等病原體所致的疾病。各類病原體可引起多種類型的感染致心血管疾病， 使患者健康嚴(yán)重受損和社會(huì)負(fù)荷沉重不堪。2、感染導(dǎo)致心血管疾病以感染性心包炎、感染性心肌炎和感染性心內(nèi)膜炎較常見，而感染性心瓣膜病多由感染性心內(nèi)膜炎引起，感染性血管炎較為少見。3、診治：在盡快留取實(shí)驗(yàn)室檢查標(biāo)

5、本（如疑診感染性心內(nèi)膜炎患者至少抽3次靜脈血進(jìn)行血培養(yǎng)，采血間隔30 min～1 h）后，應(yīng)根據(jù)循證醫(yī)學(xué)和相關(guān)指南盡早、足量、經(jīng)驗(yàn)性選用抗感染藥物。,二、內(nèi)容簡(jiǎn)介,三、分析與討論,Role of acute infection in triggering acute coronary syndromes. Lancet Infect Dis 2010; 10: 83–92,A Several mechanisms trigg

6、er the disruption of an advanced coronary lesion. The disrupted surface exposes underlying thrombogenic material. Plaque disruption alone is not su?cient for the development of an acute coronary syndrome.,B Thrombogenic

7、conditions (local and systemic) determine thrombus formation.,C The occlusive nature of the thrombus (total vs partial), the degree of stenosis, the presence of vasoconstriction, the coronary perfusion pressure, and the

8、myocardial metabolic balance (demand vs supply) determine the evolution of an acute coronary syndrome.,2. Influenza and Cardiovascular Disease：Is There a Causal Relationship? Tex Heart Inst J. 2004; 31(1): 4–13

9、.,,TABLE II. Effects of Influenza on the Coagulation System,3. Immunosuppressive Treatment for Inflammatory Cardiomyopathy. Int Heart J 2005; 46: 113-122,4.Guidelines on the prevention, diagnosis, and treatment of infect

10、ive endocarditis (new version 2009). European Heart Journal (2009) 30, 2369–2413.,感染性心內(nèi)膜炎的臨床表現(xiàn),感染性心內(nèi)膜炎的診斷標(biāo)準(zhǔn),5. Efficacy of daptomycin in the treatment of enterococcal endocarditis: a 5 year comparison with conventional t

11、herapy. J Antimicrob Chemother. 2014 ，13：PMID: 24532682,Enterococcus spp. account for 10% of infective endocarditis (IE) Although daptomycin is a bactericidal drug with in vitro activity against Enterococcus,

12、there is little experience of its use in IE. This was a retrospective descriptive study comparing the ef?cacy of daptomycin versus ampicillin/ ceftriaxone versus conventional antibiotic regimens (ampicillin or vancomyci

13、n+gentamicin) in EIE,Table 1. Baseline characteristics of the 32 patients with enterococcal infective endocarditis diagnosed during the study period,1、感染引起心血管疾病的確診比較困難，并且往往較晚，起始經(jīng)驗(yàn)治療對(duì)患者預(yù)后有著重要意義。2、病毒性心肌炎以對(duì)癥支持治療為主。雖然免疫參與了病