真性红细胞增多症合并急性心肌梗死1例

Polycythemia vera with acute myocardial infarction:a case report

真性红细胞增多症(PV)是以红系髓造血干细胞持续克隆性增殖为主要特征的一组恶性肿瘤性疾病,患者易出现动静脉血栓和出血等并发症。其中,动脉血栓形成是最常见的并发症之一,累及冠状动脉可导致急性心肌梗死(AMI)而危及生命。临床治疗AMI的常规措施主要为经皮冠脉介入术(PCI)治疗,但PV患者植入支架后易再发血栓,而目前对于PV合并AMI患者,尚无明确的治疗指南。现报道1例PV引发3次AMI患者的诊疗情况,以期为临床医师开拓思路,并早期开展筛查、制订诊疗策略,进而改善预后和生命质量。

Polycythemia vera(PV)is a group of malignant neoplastic diseases characterized by continuous clonal proliferation of erythroid myelopoietic hemopoietic stem cells,which are prone to complications such as arteriovenous thrombosis and hemorrhage.Among them,arterial thrombosis is one of the most common complications,involving the coronary arteries,which can result in acute myocardial infarction(AMI),endangering life.The conventional treatment for clinical treatment of AMI is mainly percutaneous coronary intervention(PCI),but PV patients are prone to recurrent thrombosis after artery implantation,and there are currently no clear treatment guidelines for PV patients with AMI at present.This paper reports the diagnosis and treatment process of a patient with AMI caused by PV for 3 times,which opens up new ideas for clinicians,carry out early screening,formulate diagnosis and treatment strategies,prognosis and quality of life.