心血管干预后系统性炎症反应综合征的管理. 诊断,预后和治疗影响
Carlo Mannina1, Annapoorna Kini2, Andreina Carbone3
1Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York.
The American journal of cardiology
|April 22, 2024
概括
系统性炎症反应综合征 (SIRS) 可能发生在主动脉和动脉瘤修复后. 了解其原因和提高设备生物相容性对于患者的治疗结果至关重要.
科学领域:
- 心血管外科心血管外科
- 炎症反应 炎症反应
背景情况:
- 过导管大动脉植入 (TAVI) 和内血管大动脉动脉瘤修复 (EVAR) 可以引发系统性炎症反应综合征 (SIRS).
- 术后SIRS的确切原因尚不清楚,但是内皮损伤和植入器件导致的缺血是可疑的触发因素.
- 在初始损伤和症状发作之间可能存在0-48小时的潜伏期,从局部炎症进展到全身炎症.
研究的目的:
- 在TAVI和EVAR之后,探索SIRS的机制.
- 研究减少植入心血管装置的炎症反应的潜在策略.
主要方法:
- 对SIRS术后临床表现和诊断挑战的审查.
- 分析潜在的触发因素,包括内皮干扰和异物反应.
- 检查目前的治疗策略和与SIRS相关的并发症.
主要成果:
- 由于其与感染的相似性,SIRS诊断具有挑战性;负面培养和缺乏抗生素反应支持SIRS.
- 并发症包括长时间住院,再入院,重大心血管事件和设备耐用性降低.
- 目前的治疗方法包括NSAID或皮质类固醇.
结论:
- 需要进一步的研究来阐明TAVI和EVAR之后SIRS的病理生理学.
- 提高设备材料的免疫兼容性可能会减轻宿主组织的炎症反应.
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