急性肺炎如何影响心血管系统？

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传统上认为急性肺炎是一种局限于肺部的疾病，但所有重度感染均会对心血管系统产生重要影响。 肺炎倾向于影响心血管风险也较高的个体。 最近的研究结果表明，因肺炎入院的成年人中有四分之一在住院期间发生了重大的急性心脏并发症，这些并发症会导致短期死亡率上升 60%。 这些发现表明，通过预防相关心脏并发症的发生和进展，可改善肺炎患者的预后。 但是，在检测这些假说之前，我们还需要从机制角度充分认识肺炎期间的心血管变化，及其在多种心脏并发症的触发过程中的作用。 在该综述中，我们总结了以下方面的知识：成年急性肺炎患者的心脏并发症负担，对这一感染的心血管反应，常用心血管药物和抗感染药物对这些相关性的潜在影响，以及未来可能的研究方向。

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http://www.ncbi.nlm.nih.gov/pubmed?term=Vicente%20F%20Corrales-Medina%20%2CDaniel%20M%20Musher%20%2CSvetlana%20Shachkina%20%2CJulio%20A%20Chirinos

Lancet. 2013 Jan 15. pii: S0140-6736(12)61266-5. doi: 10.1016/S0140-6736(12)61266-5. [Epub ahead of print]
Acute pneumonia and the cardiovascular system.Corrales-Medina VF, Musher DM, Shachkina S, Chirinos JA.
SourceDepartment of Medicine, University of Ottawa, ON, Canada; Ottawa Hospital Research Institute, ON, Canada. Electronic address: vcorrales@toh.on.ca.

AbstractAlthough traditionally regarded as a disease confined to the lungs, acute pneumonia has important effects on the cardiovascular system at all severities of infection. Pneumonia tends to affect individuals who are also at high cardiovascular risk. Results of recent studies show that about a quarter of adults admitted to hospital with pneumonia develop a major acute cardiac complication during their hospital stay, which is associated with a 60% increase in short-term mortality. These findings suggest that outcomes of patients with pneumonia can be improved by prevention of the development and progression of associated cardiac complications. Before this hypothesis can be tested, however, an adequate mechanistic understanding of the cardiovascular changes that occur during pneumonia, and their role in the trigger of various cardiac complications, is needed. In this Review, we summarise knowledge about the burden of cardiac complications in adults with acute pneumonia, the cardiovascular response to this infection, the potential effects of commonly used cardiovascular and anti-infective drugs on these associations, and possible directions for future research.
Copyright © 2013 Elsevier Ltd. All rights reserved.