中国实用外科杂志2024，Vol.44Issue(12)：1362-1366,5.DOI:10.19538/j.cjps.issn1005-2208.2024.12.09
布鲁菌病相关主动脉感染性疾病诊治现状
Current status of diagnosis and treatment of brucellosis-related aortic infectious diseases
摘要
Abstract
Brucellosis is a zoonotic infectious disease transmitted from livestock to humans,commonly affecting the bones,joints,and spine.While cardiovascular complications are rare,brucellosis involving the aorta progresses rapidly and is associated with high mortality.Brucellosis-related aortic infectious diseases primarily manifest as infectious aortitis,which may progress to an infectious aortic aneurysm.The causative agent is Brucella,which enters the human body through the skin or mucosa and disseminates systemically via the lymphatic system,leading to aortic infection.The primary pathogenesis involves inflammatory changes in the arterial wall and upregulation of matrix metalloproteinases.The diagnosis of brucellosis-related aortic infectious diseases relies on a combination of serological tests,imaging studies,and clinical presentations.Imaging modalities such as CT,MRI,and ultrasound aid in confirming brucellosis-related aortic aneurysms.CT and 18F-FDG PET/CT exhibit high sensitivity in detecting disease progression.Clinical presentations often include abdominal pain and back pain,which are nonspecific,necessitating further confirmation through serological and imaging assessments.The treatment of brucellosis-related aortic infectious diseases primarily involves antibiotic therapy and surgical intervention.Early and broad-spectrum antibiotic therapy combining rifampin and doxycycline is recommended,with a typical treatment duration of six months.Endovascular repair has become the preferred treatment modality for aortic infectious diseases,offering advantages over traditional open surgery,including reduced invasiveness,faster recovery,and favorable short-term outcomes.Open surgery remains dominant in managing complex cases,particularly when endovascular therapy is insufficient to address the condition effectively.Postoperative anti-infective therapy and long-term follow-up are crucial for improving patient prognosis.Treatment strategies for brucellosis-related aortic infectious diseases should be tailored to individual cases.Endovascular therapy has demonstrated promising clinical outcomes.关键词
布鲁菌病/主动脉感染性疾病/感染性主动脉瘤/血管内治疗/开放手术/CT/MRI/18氟-脱氧葡萄糖正电子发射计算机断层扫描(18F-FDG PET/CT)Key words
brucellosis/aortic infectious disease/infectious aortic aneurysm/endovascular repair/open surgery/CT/MRI/18F-FDG PET/CT分类
医药卫生引用本文复制引用
王雷,王嘉谊,辛世杰..布鲁菌病相关主动脉感染性疾病诊治现状[J].中国实用外科杂志,2024,44(12):1362-1366,5.基金项目
辽宁省科学计划项目(No.2023JH2/101700088,No.2022JH1/10400002) （No.2023JH2/101700088,No.2022JH1/10400002）
