单纯急性右冠状动脉闭塞并发肺水肿三例报告并文献复习

Acute Right Coronary Artery Occlusion Complicated with Pulmonary Edema:Three Cases of Report and Literature Review

目的了解单纯急性右冠状动脉闭塞并发肺水肿的临床特点,探讨其可能的发病机制。方法选取我院2012年1月—2013年3月收治的3例单纯急性右室心肌梗死并发严重肺水肿病例,对其临床表现、影像学特点等加以分析,并复习相关文献。结果 3例单纯急性右冠状动脉闭塞并发肺水肿均与急性左心功能衰竭、室间隔破裂、左房室瓣瓣膜损伤及过度输液无关,推测可能与交感神经过度兴奋释放大量儿茶酚胺及机体释放大量炎性因子损伤肺泡上皮细胞机制有关。结论单纯急性右冠状动脉闭塞所致心肌梗死很可能通过交感神经过度释放儿茶酚胺及机体释放大量炎性因子损伤肺泡上皮细胞引起肺水肿。

Objective To understand the clinical features of acute right coronary artery occlusion complicated with pulmonary edema and explore its possible pathogenesis.Methods We selected 3 cases of this disease admitted in our hospital from January 2012 to March 2013,analyzed their clinical manifestations and imaging features,and reviewed the related literature.Results The acute left heart failure,ventricular septal rupture,mitral valve damages and excessive transfusion were not the reasons for the complication with pulmonary edema.We hypothesized that it might be related to the damages of alveolar epithelial cell mechanism caused by large amounts of catechins release from sympathetic overactivity and inflammatory factors release from human body.Conclusion Acute right coronary artery occlusion inducing myocardial infartion is probably due to pulmonary edema caused by the alveolar epithelial cell damage through excessive sympathetic catecholamine release and the release of inflammatory factors.