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肾移植后急性心肌梗死经皮冠状动脉介入治疗:来自临床病例报告的宝贵经验。

Acute myocardial infarction after renal transplantation treated with percutaneous coronary intervention: a valuable lesson from a clinical case report.

机构信息

Department of Cardiology of Third Xiangya Hospital attached to Central South University, Changsha, China.

出版信息

Ann Palliat Med. 2021 Jun;10(6):7028-7032. doi: 10.21037/apm-20-962. Epub 2020 Dec 15.

Abstract

Acute myocardial infarction has been reported to be a common clinical complication after renal transplantation. This case report involves a retrospective review of the clinical management of a 56-year-old woman with a history of renal transplantation, who developed acute myocardial infarction and was treated with percutaneous coronary intervention and anti-coagulation therapy. After the treatment of percutaneous coronary intervention and anti-coagulation therapy, she was then readmitted to the hospital with upper gastrointestinal bleeding, renal calculus formation, and subsequent kidney injury. The unique of this case is that we encountered a patient who had acute myocardial infarction after renal transplantation with percutaneous coronary intervention treatment, with complications involving renal calculus formation and upper gastrointestinal bleeding. And we outline the risk factors of complications and the risk factors of anti-rejection and anti-coagulant drug therapies that had been prescribed to manage her renal transplantation and acute myocardial infarction. The lesson that we can learn from this clinical case report is that the follow-up management concerning patients with acute myocardial infarction after renal transplantation with percutaneous coronary intervention treatment is vital in the clinic and should be strengthened.

摘要

据报道,急性心肌梗死是肾移植后的常见临床并发症。本病例报告回顾性分析了一位 56 岁女性肾移植后发生急性心肌梗死的临床处理方法,该患者接受了经皮冠状动脉介入治疗和抗凝治疗。经皮冠状动脉介入治疗和抗凝治疗后,她因上消化道出血、肾结石形成和随后的肾损伤再次入院。本病例的独特之处在于,我们遇到了一位肾移植后接受经皮冠状动脉介入治疗的急性心肌梗死患者,并发肾结石形成和上消化道出血。我们概述了导致并发症的风险因素以及用于治疗肾移植和急性心肌梗死的抗排斥和抗凝药物治疗的风险因素。从这个临床病例报告中可以吸取的教训是,对接受经皮冠状动脉介入治疗的肾移植后急性心肌梗死患者的后续管理在临床上至关重要,应该得到加强。

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