摘要
目的:回顾性分析原发性血小板增多症患者合并心肌梗死特点、治疗及预后,为临床实践积累经验。方法:收集并回顾性分析2003-01至2015—07我院心内科收治的10例原发性血小板增多症合并心肌梗死患者的病例资料,包括一般资料、入院主诉、既往史、外周血血小板计数、超声心动图、冠状动脉造影、抗血小板药物、降血小板治疗、预后等情况。结果:10例患者中男性6例,女性4例,均为ST段抬高的心肌梗死。平均年龄(55.3±9.7)岁。急性心肌梗死7例,陈旧性心肌梗死3例。入院时血小板3例(500—599)×10^9/L、1例(600,699)×10^9/L、3例(700~799)×10^9/L、1例(800~899)×10^9/L、1例(900~999)×10^9/L、1例大于1000×10^9/L。超声心动图左心室射血分数≤50%5例、〉50%5例。冠状动脉造影示累及前降支9例,累及回旋支2例,累及右冠脉5例。所有患者术前接受双抗血小板药物治疗。4例患者术前服用羟基脲治疗20~30天,术后无心血管事件;6例患者术前未服羟基脲降血小板治疗,术后1例因发作心绞痛再入院,2例冠状动脉病变进展。结论:介入治疗前、后应用降血小板治疗可能有助于改善预后。
Objective: To analyze the characteristics, treatment and prognosis in patients with essential thrombocythemia (ET) combining myocardial infarction (MI). Methods: A total of 10 patients with ET combining MI treated in our hospital from 2003-01 to 2015-07 were retrospectively studied. The basic clinical information with major admission complaints, previous history and peripheral platelet counts were recorded; echocardiograph, coronary angiography (CAG), application of anti-platelet drugs and platelet reductive therapy with the prognosis were recorded in all patients. Results: There were 6 male and 4 female with a mean age of (55.3 ±9.7) years, 7 patients with AMI and 3 with old MI. The platelet counts at admission were (500-599) ×10^9/L in 3 patients, (600-699)×10^9/L in 1 patient, (700-799) ×10^9/L in 3 patients, (800- 899) ×10^9/L in 1 patients, (900-999) ×10^9/L in 1 patient and more than 1000 ×10^9/L in 1 patient. Echocardiograph indicated that 5 patient had LVEF ≤50% and 5 had LVEF〉50%. CAG revealed that there were 9 cases with left anterior descending involved, 2 with circumflex involved and 5 with fight coronary involved. All patients received dual anti-platelet drugs before operation, 4 had hydroxyurea for (20-30) days before operation and no post-operative cardiovascular events occurred; 6 patients without hydroxyurea medication and 1 of them was re-hospitalized for angina pectoris and 2 had progressed coronary lesions. Conclusion: Application of platelet reductive therapy at before and after interventional treatment may improve the prognosis in patients with ET combining MI.
出处
《中国循环杂志》
CSCD
北大核心
2016年第2期119-121,共3页
Chinese Circulation Journal
关键词
心肌梗死
血小板增多
血栓形成
Myocardial infarction
Essential thrombocythemia
Thrombosis