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氯吡格雷致 ST 段抬高型心肌梗死患者发生肺出血

Pulmonary Alveolar Hemorrhage after Clopidogrel Use for ST Elevation Myocardial Infarction.

机构信息

Division of Cardiology, Department of Internal Medicine, Konkuk University College of Medicine, Chungju, Korea.

出版信息

Korean Circ J. 2013 Jul;43(7):497-9. doi: 10.4070/kcj.2013.43.7.497. Epub 2013 Jul 31.

DOI:10.4070/kcj.2013.43.7.497
PMID:23964298
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3744739/
Abstract

Combination treatment of antiplatelet drugs containing aspirin and clopidogrel reduces systemic ischemic events after percutaneous coronary intervention (PCI) in high risk patients. However, this combination treatment of antiplatelet drugs is associated with increased risk of nonfatal and fatal bleeding. Diffuse alveolar hemorrhage after PCI is a rare complication that has been mostly reported in association with glycoprotein IIb/IIIa inhibitors. We report the case of a 62-year-old man who presented with ST elevation myocardial infarction and suffered a diffuse alveolar hemorrhage after clopidogrel use following primary PCI.

摘要

双联抗血小板治疗（包含阿司匹林和氯吡格雷）可降低高危经皮冠状动脉介入治疗（PCI）患者的系统性缺血事件。然而，这种双联抗血小板药物治疗与非致死性和致死性出血风险增加相关。PCI 后弥漫性肺泡出血是一种罕见的并发症，主要与糖蛋白 IIb/IIIa 抑制剂相关。我们报告了一例 62 岁男性患者，因 ST 段抬高型心肌梗死就诊，在初次 PCI 后使用氯吡格雷后发生弥漫性肺泡出血。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/91fd/3744739/c9ef5eed3ccf/kcj-43-497-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/91fd/3744739/571b7d0f0eef/kcj-43-497-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/91fd/3744739/4112c33c0ef1/kcj-43-497-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/91fd/3744739/c9ef5eed3ccf/kcj-43-497-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/91fd/3744739/571b7d0f0eef/kcj-43-497-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/91fd/3744739/4112c33c0ef1/kcj-43-497-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/91fd/3744739/c9ef5eed3ccf/kcj-43-497-g003.jpg

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本文引用的文献

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Diffuse alveolar hemorrhage as a complication of dual antiplatelet therapy for acute coronary syndrome.弥漫性肺泡出血作为急性冠状动脉综合征双联抗血小板治疗的并发症
Cardiovasc Revasc Med. 2011 Nov-Dec;12(6):407-11. doi: 10.1016/j.carrev.2011.03.003. Epub 2011 Apr 21.
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Risk of bleeding with single, dual, or triple therapy with warfarin, aspirin, and clopidogrel in patients with atrial fibrillation.心房颤动患者使用华法林、阿司匹林和氯吡格雷进行单药、双药或三药治疗时的出血风险。
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Double-dose versus standard-dose clopidogrel and high-dose versus low-dose aspirin in individuals undergoing percutaneous coronary intervention for acute coronary syndromes (CURRENT-OASIS 7): a randomised factorial trial.
Ther Clin Risk Manag. 2021 Jul 12;17:711-715. doi: 10.2147/TCRM.S319077. eCollection 2021.
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Severe acute respiratory failure due to a multifactorial diffuse alveolar haemorrhage.多因素所致弥漫性肺泡出血引起的严重急性呼吸衰竭
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Pulmonary alveolar hemorrhage mimicking a pneumopathy: a rare complication of dual antiplatelet therapy for ST elevation myocardial infarction.酷似肺病的肺泡出血：ST段抬高型心肌梗死双联抗血小板治疗的罕见并发症
Pan Afr Med J. 2016 Aug 11;24:308. doi: 10.11604/pamj.2016.24.308.8828. eCollection 2016.
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2009 focused updates: ACC/AHA guidelines for the management of patients with ST-elevation myocardial infarction (updating the 2004 guideline and 2007 focused update) and ACC/AHA/SCAI guidelines on percutaneous coronary intervention (updating the 2005 guideline and 2007 focused update) a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines.2009年重点更新：美国心脏病学会/美国心脏协会ST段抬高型心肌梗死患者管理指南（更新2004年指南和2007年重点更新内容）以及美国心脏病学会/美国心脏协会/心血管造影和介入学会经皮冠状动脉介入治疗指南（更新2005年指南和2007年重点更新内容）——美国心脏病学会基金会/美国心脏协会实践指南工作组报告
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Benefits and risks of the combination of clopidogrel and aspirin in patients undergoing surgical revascularization for non-ST-elevation acute coronary syndrome: the Clopidogrel in Unstable angina to prevent Recurrent ischemic Events (CURE) Trial.氯吡格雷与阿司匹林联合应用于非ST段抬高型急性冠状动脉综合征患者外科血运重建的获益与风险：氯吡格雷用于不稳定型心绞痛预防再发缺血事件（CURE）试验
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Effects of aspirin dose when used alone or in combination with clopidogrel in patients with acute coronary syndromes: observations from the Clopidogrel in Unstable angina to prevent Recurrent Events (CURE) study.阿司匹林单独使用或与氯吡格雷联合使用对急性冠状动脉综合征患者的影响：来自“氯吡格雷用于不稳定型心绞痛预防再发事件（CURE）”研究的观察结果
Circulation. 2003 Oct 7;108(14):1682-7. doi: 10.1161/01.CIR.0000091201.39590.CB. Epub 2003 Sep 22.
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Combined therapy with clopidogrel and aspirin significantly increases the bleeding time through a synergistic antiplatelet action.氯吡格雷与阿司匹林联合治疗通过协同抗血小板作用显著延长出血时间。
J Vasc Surg. 2002 Jun;35(6):1204-9. doi: 10.1067/mva.2002.122027.
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Diffuse alveolar hemorrhage after clopidogrel use.使用氯吡格雷后出现弥漫性肺泡出血。
J Invasive Cardiol. 2001 Jul;13(7):535-7.