肺动静脉畸形与隐源性卒中

Pulmonary arteriovenous malformation and cryptogenic stroke

肺动静脉畸形(pulmonary arteriovenous malformations,PAVMs)与卒中的关系目前尚不明确。随着影像学技术的发展,研究显示PAVMs是隐源性卒中(cryptogenic stroke,CS)的重要病因。大多数PAVMs直到卒中发病时才得以诊断,主要发病机制为反常性栓塞以及缺铁性贫血导致血液黏稠度增高等。抗血小板治疗和介入治疗可能对此类患者的复发性卒中具有预防作用。文章总结了PAVMs相关性CS的病理生理学机制、诊断和治疗,期望为CS的诊治提供新思路。

The relationship between pulmonary arteriovenous malformations(PAVMs)and stroke remains unclear.With the development of imaging technology,studies shows that PAVMs are an important cause of cryptogenic stroke(CS).Most PAVMs are not diagnosed until the onset of stroke.The main pathogenesis of PAVMs-related CS is paradoxical embolism and increased blood viscosity caused by iron deficiency anemia.Antiplatelet therapy and interventional therapy may have a preventive effect on recurrent stroke in such patients.This article summarizes the pathophysiological mechanism,diagnosis and treatment of PAVMs-related CS,hoping to provide new ideas for the diagnosis and treatment of CS.