特发性血小板减少性紫癜患者急性心肌梗死的管理：光学相干断层扫描的价值：一例报告
Management of acute myocardial infarction in a patient with idiopathic thrombocytopenic purpura, the value of optical coherence tomography: a case report.
作者信息
Al-Lawati Kumayl, Osheiba Mohammed, Lester Will, Khan Sohail Q
机构信息
Department of Cardiology, Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust, Mindelsohn Way, Edgbaston, B15 2TH Birmingham, UK.
Royal Hospital, National Heart Centre, Ministry of Health, Al-Ghubrah, Muscat, Oman.
出版信息
Eur Heart J Case Rep. 2020 Dec 2;4(6):1-5. doi: 10.1093/ehjcr/ytaa460. eCollection 2020 Dec.
BACKGROUND
Treating myocardial infarction in the setting of immune thrombocytopenic purpura (ITP) is always a challenge especially if the platelet count is labile. Cardiologists dealing with such patients should keep a delicate balance between thrombotic and bleeding complications.
CASE SUMMARY
A 50-year-old gentleman with treatment-challenging ITP presented with acute inferior ST elevation myocardial infarction after receiving recent intravenous immunoglobulin. Using optical coherence tomography (OCT) guidance, it was decided to treat him with percutaneous old balloon angioplasty especially with the labile nature of his platelet count. Subsequently, dual antiplatelet therapy was a challenge and he remained on clopidogrel for a period of only 10 weeks.
CONCLUSION
This case highlights the rare presentation of patients with ITP with thrombotic complications and the usefulness of OCT in formulating a management plan.
背景
在免疫性血小板减少性紫癜（ITP）背景下治疗心肌梗死一直是一项挑战，尤其是当血小板计数不稳定时。处理此类患者的心脏病专家应在血栓形成和出血并发症之间保持微妙的平衡。
病例摘要
一名患有具有治疗挑战性的ITP的50岁男性，在近期接受静脉注射免疫球蛋白后出现急性下壁ST段抬高型心肌梗死。在光学相干断层扫描（OCT）引导下，鉴于其血小板计数不稳定的特性，决定对他进行经皮陈旧球囊血管成形术治疗。随后，双重抗血小板治疗颇具挑战性，他仅服用氯吡格雷10周。
结论
本病例突出了ITP患者出现血栓形成并发症的罕见表现以及OCT在制定管理计划中的作用。
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