类风湿关节炎合并易栓症致肺栓塞1例

A case report of pulmonary embolism caused by rheumatoid arthritis combined with thrombophilia

高凝状态是易栓症的特征性描述,发生静脉血栓的风险较高,由此产生的深静脉血栓涉及肺动脉及下肢深静脉。易栓症可由自身基因突变引起,也可继发于自身免疫性疾病,且在多次的血栓事件后才可被诊断。本文报道1例67岁男性患者,既往类风湿关节炎病史10年,此次主因“间断胸闷、气短3 d”就诊,通过病史采集,体格检查及相关辅助检查,明确诊断为急性肺栓塞、易栓症、类风湿关节炎。经过溶栓和抗凝等治疗,患者症状好转。临床中引起肺栓塞的病因较多,当我们怀疑存在易栓症时,应重点询问家族史、既往史和个人史,达到早诊断、个体化治疗和提高患者生活质量的目的。

Hypercoagulable state is a characteristic description of thrombophilia,and patients have high risk of venous thrombosis.The resulting deep venous thrombosis involves pulmonary artery and lower extremity deep vein.Thrombophilia can be caused by its own gene mutation or secondary to autoimmune diseases,and is diagnosed after multiple thrombotic events.This paper reports a 67 years old male with rheumatoid arthritis for 10 years.The main reason of this visit was"intermittent chest tightness and shortness of breath for 3 d".Through medical history collection,physical examination and relevant auxiliary examinations,it was clearly diagnosed as acute pulmonary embolism,thrombophilia and rheumatoid arthritis.After thrombolytic and anticoagulant treatment,the patient's symptoms improved.There are many causes of pulmonary embolism in clinic.We should focus on family history,past history and personal history when suspect the existence of thrombophilia,so as to achieve the purpose of early diagnosis,individualized treatment and improving the quality of life of patients.