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冠状动脉疾病合并骨髓增生异常综合征伴血小板减少患者的抗血小板治疗

Antiplatelet Therapy in a Patient with Coronary Artery Disease and Myelodysplastic Syndrome with Thrombocytopenia.

作者信息

Fernández-Fernández Francisco José, Ameneiros-Lago Eugenia, Tuñas-Gesto Cintia, Gómez-Buela Inmaculada

机构信息

Department of Internal Medicine, Complejo Hospitalario Universitario de Ferrol, Ferrol 15405, Spain.

Section of Neurology, Complejo Hospitalario Universitario de Ferrol, Ferrol 15405, Spain.

出版信息

Acta Medica (Hradec Kralove). 2017;60(2):82-84. doi: 10.14712/18059694.2017.98.

Abstract

To date, there are no sufficient data to make firm recommendations on the treatment of patients with severe thrombocytopenia who require antiplatelet therapy after experiencing acute coronary syndrome. Therefore, we think that it is important to communicate the experience with individual cases. We report the case of a patient who presented with pericardial effusion causing cardiac tamponade. He had thrombocytopenia associated with myelodysplastic syndrome, and ten weeks before this admission, percutaneous transluminal coronary angioplasty with implantation of drug-eluting stents was performed for non-ST-segment elevation acute coronary syndrome. Platelets in myelodysplastic syndromes are dysfunctional, which exacerbates bleeding from thrombocytopenia, and the management of atherosclerotic cardiovascular disease in these patients is challenging.

摘要

迄今为止,尚无足够数据对急性冠状动脉综合征后需要抗血小板治疗的严重血小板减少症患者的治疗提出明确建议。因此,我们认为交流个别病例的经验很重要。我们报告一例出现心包积液导致心脏压塞的患者。他患有与骨髓增生异常综合征相关的血小板减少症,此次入院前10周,因非ST段抬高型急性冠状动脉综合征接受了经皮腔内冠状动脉成形术并植入药物洗脱支架。骨髓增生异常综合征中的血小板功能异常,这会加剧血小板减少引起的出血,并且这些患者的动脉粥样硬化性心血管疾病管理具有挑战性。

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