原发性血小板减少性紫癜患者急性心肌梗死的直接经皮冠状动脉介入治疗。病例报告及文献复习。
Primary PCI for acute myocardial infarction in a patient with idiopathic thrombocytopenic purpura. A case report and review of the literature.
作者信息
Neskovic Aleksandar N, Stankovic Ivan, Milicevic Predrag, Aleksic Aleksandar, Vlahovic-Stipac Alja, Calija Branko, Putnikovic Biljana
机构信息
Cardiac Catheterization Laboratory, Clinical Hospital Center Zemun, Belgrade University School of Medicine, Belgrade, Serbia.
出版信息
Herz. 2010 Jan;35(1):43-9. doi: 10.1007/s00059-010-3262-1. Epub 2010 Feb 9.
BACKGROUND AND PURPOSE
The occurrence of acute myocardial infarction (AMI) in patients with idiopathic thrombocytopenic purpura (ITP) is rare, especially when the platelet count is low. Since only few case reports have been published, there are no recommendations for the management of thrombocytopenic patients with AMI. The aim of the present study is to discuss different aspects of this challenging issue and to review limited data available in the literature.
CASE STUDY
An 80-year-old patient with ITP (platelet count 5 . 10(9)/l) is presented who developed an AMI (ST segment elevation myocardial infarction) and was successfully treated by primary percutaneous coronary intervention (PCI).
CONCLUSION
Considering the high bleeding risk in patients with ITP and AMI, careful balance between usual anticoagulation and antiplatelet therapy on the one hand, and efforts to raise platelet count on the other hand are needed.
背景与目的
特发性血小板减少性紫癜（ITP）患者发生急性心肌梗死（AMI）的情况较为罕见，尤其是在血小板计数较低时。由于仅有少数病例报告发表，对于血小板减少合并AMI患者的管理尚无推荐意见。本研究的目的是探讨这一具有挑战性问题的不同方面，并回顾文献中有限的数据。
病例研究
报告一名80岁的ITP患者（血小板计数5×10⁹/L），该患者发生了AMI（ST段抬高型心肌梗死），并通过直接经皮冠状动脉介入治疗（PCI）获得成功治疗。
结论
鉴于ITP合并AMI患者的出血风险较高，一方面需要在常规抗凝和抗血小板治疗之间仔细权衡，另一方面需要努力提高血小板计数。
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