Nakajima Tomohiro, Mukawa Kei, Iba Yutaka, Iwashiro Yu, Kawaharada Nobuyoshi
Cardiovascular Surgery, Sapporo Medical University, Sapporo, JPN.
Cureus. 2024 Jul 3;16(7):e63787. doi: 10.7759/cureus.63787. eCollection 2024 Jul.
Essential thrombocythemia (ET) is a myeloproliferative neoplasm characterized by persistent elevation of platelet count due to abnormal proliferation of megakaryocytes. While some cases may be asymptomatic, the condition is associated with an increased risk of complications such as thrombosis and bleeding tendencies, necessitating appropriate management tailored to individual cases. Hemostasis analyzer systems are automated analytical devices designed for comprehensive evaluation of blood coagulation function. These systems enable rapid and accurate measurement of multiple parameters, including coagulation time, platelet function, and fibrin formation, thus facilitating a holistic assessment of hemostatic function. A 76-year-old male patient presented to our hospital. At the age of 65, he received treatment for promyelocytic leukemia and achieved remission. At 75 years, he developed leukocytosis, thrombocytosis, and progressive anemia. A comprehensive examination, including bone marrow biopsy and genetic testing, revealed a JAK2 mutation, leading to the diagnosis of ET. At the age of 76 years, he complained of chest discomfort during exertion. Further investigation revealed severe aortic valve stenosis and two-vessel coronary artery disease. The patient underwent aortic valve replacement and three-vessel coronary artery bypass grafting. A hemostasis analyzer system was used to monitor coagulation function throughout the procedure. Compared with the normal range, his coagulation profile showed a tendency toward hypercoagulability. Intraoperative and postoperative transfusions were performed as required. The patient's postoperative course was uneventful without any complications related to bleeding or thrombosis.
原发性血小板增多症（ET）是一种骨髓增殖性肿瘤，其特征是由于巨核细胞异常增殖导致血小板计数持续升高。虽然有些病例可能无症状，但该病症与血栓形成和出血倾向等并发症风险增加相关，因此需要针对个体病例进行适当管理。止血分析仪系统是用于全面评估血液凝固功能的自动化分析设备。这些系统能够快速、准确地测量多个参数，包括凝血时间、血小板功能和纤维蛋白形成，从而有助于对止血功能进行整体评估。一名76岁男性患者前来我院就诊。65岁时，他接受了早幼粒细胞白血病治疗并实现缓解。75岁时，他出现白细胞增多、血小板增多和进行性贫血。包括骨髓活检和基因检测在内的全面检查发现了JAK2突变，从而诊断为ET。76岁时，他在运动时抱怨胸部不适。进一步检查发现严重主动脉瓣狭窄和双支冠状动脉疾病。该患者接受了主动脉瓣置换术和三支冠状动脉搭桥术。在整个手术过程中使用止血分析仪系统监测凝血功能。与正常范围相比，他的凝血指标显示有高凝倾向。根据需要进行了术中及术后输血。患者术后病程顺利，未出现任何与出血或血栓形成相关的并发症。
