案例报告:死后的大脑和心脏病理揭示了同时存在的急性缺血性中风和心电图异常的发病原因
Yorito Hattori1, Shuhei Ikeda1, Manabu Matsumoto2
1Department of Neurology, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan.
Frontiers in cardiovascular medicine
|June 30, 2023
概括
这项尸体解剖研究显示,心房动 (AF) 可以导致左心房附属体中相同的纤维素血栓,导致同时发生大脑和冠状动脉栓塞. 这一发现澄清了心脑梗塞 (CCI) 的病理学.
科学领域:
- 心脏病学 心脏病学
- 神经学 神经学
- 病理学 病理学 病理学
背景情况:
- 电心电图异常偶尔与中风一起报告,但直接的因果关系尚不清楚.
- 同时发生的中风和心电图异常需要快速诊断.
- 心脑梗塞 (CCI),同时脑和心肌梗塞,很少发生,病理机制不明.
研究的目的:
- 为了调查患有同时发生急性缺血性中风和心电图异常的患者的病理发现.
- 为了阐明心脑梗塞 (CCI) 的病理机制.
主要方法:
- 一位92岁的女性患者的尸检,她出现了突然昏迷和急性缺血性中风.
- 在左心房附属体,大脑动脉和冠状动脉中对纤维素壁血栓的病理评估.
- 使用CD31,CD68和CD168标记物的免疫组织化学分析.
主要成果:
- 在左心房附属体 (LAA),大脑动脉和冠状动脉中发现了纤维素壁血栓.
- 三个部位的血栓都显示出类似的免疫组织化学发现 (CD31+,CD68+,CD168+),这表明它们是相同的.
- 心房 (AF) 存在,这意味着LAA血栓是栓塞的来源.
结论:
- 该研究提供了CCI的第一个明确的病理证据,将AF诱导的LAA血栓与同时发生的大脑和冠状动脉栓塞联系起来.
- 这一发现澄清了CCI的病态机制.
- 需要进行进一步的病理学研究,以确定CCI的明确病理机制和预防策略.
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