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一例老年急性冠状动脉综合征患者因替格瑞洛负荷剂量治疗导致的肝实质内出血病例。

A Case of Intraparenchymal Hepatic Hemorrhage Due to Ticagrelor Loading Treatment in an Elderly Patient With Acute Coronary Syndrome.

作者信息

Kaynak Cagdas, Aslan Muzaffer

机构信息

Cardiology, Siirt Education Research Hospital, Siirt, TUR.

出版信息

Cureus. 2021 Feb 12;13(2):e13318. doi: 10.7759/cureus.13318.

DOI:10.7759/cureus.13318
PMID:33738162
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7959875/
Abstract

Ticagrelor is a potent P2Y12 inhibitor that is increasingly used in acute coronary syndrome. Although drug-related intrahepatic hemorrhages have been reported with anticoagulant drugs, no case of intrahepatic hemorrhage due to ticagrelor has been encountered in the literature. With this case, we tried to explain that potent antiaggregant drugs may cause this rare bleeding complication. Although ticagrelor is used for rapid antiaggregation effect in acute coronary syndrome, de-escalation to clopidogrel treatment in elderly patients during the hospitalization period is a more reasonable option.

摘要

替格瑞洛是一种强效P2Y12抑制剂，在急性冠脉综合征中使用越来越广泛。虽然已有抗凝药物导致药物相关性肝内出血的报道，但文献中尚未有替格瑞洛引起肝内出血的病例。通过本病例，我们试图说明强效抗血小板药物可能会导致这种罕见的出血并发症。尽管替格瑞洛用于急性冠脉综合征的快速抗血小板作用，但老年患者在住院期间降级为氯吡格雷治疗是更合理的选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4bca/7959875/d76a6b189140/cureus-0013-00000013318-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4bca/7959875/7f9621ef714f/cureus-0013-00000013318-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4bca/7959875/d76a6b189140/cureus-0013-00000013318-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4bca/7959875/7f9621ef714f/cureus-0013-00000013318-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4bca/7959875/d76a6b189140/cureus-0013-00000013318-i02.jpg

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A Case of Intraparenchymal Hepatic Hemorrhage Due to Ticagrelor Loading Treatment in an Elderly Patient With Acute Coronary Syndrome.一例老年急性冠状动脉综合征患者因替格瑞洛负荷剂量治疗导致的肝实质内出血病例。
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本文引用的文献

1
Comparison Between Ticagrelor and Clopidogrel in Elderly Patients With an Acute Coronary Syndrome: Insights From the SWEDEHEART Registry.替格瑞洛与氯吡格雷在老年急性冠状动脉综合征患者中的比较：来自 SWEDEHEART 注册研究的结果。
Circulation. 2020 Nov 3;142(18):1700-1708. doi: 10.1161/CIRCULATIONAHA.120.050645. Epub 2020 Sep 1.
2
Ticagrelor versus clopidogrel in patients with STEMI treated with thrombolysis: the MIRTOS trial.替卡格雷与氯吡格雷在溶栓治疗的 STEMI 患者中的比较：MIRTOS 试验。
EuroIntervention. 2021 Feb 19;16(14):1163-1169. doi: 10.4244/EIJ-D-20-00268.
3
Updated Expert Consensus Statement on Platelet Function and Genetic Testing for Guiding P2Y Receptor Inhibitor Treatment in Percutaneous Coronary Intervention.
更新的血小板功能和基因检测指导经皮冠状动脉介入治疗中 P2Y 受体抑制剂治疗的专家共识声明。
JACC Cardiovasc Interv. 2019 Aug 26;12(16):1521-1537. doi: 10.1016/j.jcin.2019.03.034. Epub 2019 Jun 12.
4
De-escalation from ticagrelor to clopidogrel in acute coronary syndrome patients: a systematic review and meta-analysis.替格瑞洛转换为氯吡格雷在急性冠脉综合征患者中的应用：系统评价和荟萃分析。
J Thromb Thrombolysis. 2019 Jul;48(1):1-10. doi: 10.1007/s11239-019-01860-7.
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Diffuse alveolar hemorrhage associated with ticagrelor therapy after percutaneous coronary intervention.经皮冠状动脉介入治疗后替格瑞洛治疗相关的弥漫性肺泡出血
Anatol J Cardiol. 2018 Jul;20(1):60-61. doi: 10.14744/AnatolJCardiol.2018.47776.
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Ticagrelor in modern cardiology - an up-to-date review of most important aspects of ticagrelor pharmacotherapy.替格瑞洛在现代心脏病学中的应用——替格瑞洛药物治疗最重要方面的最新综述
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