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JACC：血小板活化或促社区获得性肺炎患者发生心梗

2014-11-05 高晓方 译 医学论坛网

血小板活化社区获得性肺炎患者心梗
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意大利一项研究表明，血小板活化为社区获得性肺炎(CAP)和心梗的相关性机制，但单独应用阿司匹林可能不足以降低心梗风险。论文11月4日在线发表于《美国心脏病学会杂志》(J Am Coll Cardiol)。 此项研究共纳入278例CAP住院患者并随访至患者出院，其中144例患者hs-cTnT水平升高(>0.014 µg/L)。大部分患者为孤立性hs-cTnT升高，31例患者则伴有急性

意大利一项研究表明，血小板活化为社区获得性肺炎(CAP)和心梗的相关性机制，但单独应用阿司匹林可能不足以降低心梗风险。论文11月4日在线发表于《美国心脏病学会杂志》(J Am Coll Cardiol)。

此项研究共纳入278例CAP住院患者并随访至患者出院，其中144例患者hs-cTnT水平升高(>0.014 µg/L)。大部分患者为孤立性hs-cTnT升高，31例患者则伴有急性心梗征象(hs-cTnT浓度增加和心电图改变或有症状)。非ST-段抬高型心梗、STEMI和致命性心梗分别为26、2和3例。

与未形成心梗的CAP患者相比，心梗患者的可溶-P选择素和可溶CD40配体等血小板活化标志物显著升高，血清血栓素B2亦显著升高。在应用和未应用阿司匹林的CAP患者中，心梗发生率无显著差异，这提示抑制血栓素生物合成不足以预防心梗。

美国西奈山伊坎医学院Badimon博士指出，相关结果提示，伴有严重CAP的患者应每日监测hs-cTnT和心电图以排除心梗，由于心梗可能为无症状性并且可升高死亡风险，因此上述监测在入院头两天尤为重要。无心电图改变患者的hs-cTnT升高可能由应激或其他非特异性心肌细胞毒性因素所引起。

原始出处：

Cangemi R, Casciaro M, Rossi E, et al. Platelet activation is associated with myocardial infarction in patients with pneumonia. J Am Coll Cardiol 2014; 64:1917-25.

Santos-Gallego CG. Badimon JJ. The sum of two evils. Pneumonia and myocardial infarction: Is platelet activation the missing link? J Am Coll Cardiol 2014; 64:1926-1928.



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    2015-04-01 hbwxf

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    2015-03-17 pandamao2010

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    2014-11-07 12498568m50暂无昵称

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