韩业晨,谢洪智,张抒扬

• 1:中国医学科学院北京协和医学院北京协和医院心内科

摘要(Abstract)：

目的回顾性分析原发性血小板增多症患者行经皮冠状动脉介入治疗(PCI)的特点、治疗及预后。方法收集2010年1月至2017年7月北京协和医院心内科收治的9例原发性血小板增多症患者因合并有冠心病后行PCI的临床资料,并对PCI数据、术后药物治疗和长期随访结果进行回顾性分析。结果 9例患者中男性5例,女性4例,平均年龄(60.9±14.3)岁;急性心肌梗死患者3例,陈旧性心肌梗死患者2例,不稳定型心绞痛患者2例,稳定性冠心病患者2例;单支病变患者4例,多支病变5例;所有患者均置入药物洗脱支架,PCI术前血小板计数(596±233)×109/L,其中4例住院期间诊断原发性血小板增多症患者血小板计数为(803±105)×109/L;所有患者术后均接受阿司匹林联合氯吡格雷的双联抗血小板治疗,8例患者同时长期服用羟基脲,平均随访(53.2±26.9)个月,术后随访期间血小板计数(485±133)×109/L,随访期间无不良心血管事件发生,仅有1例患者因胃溃疡出现消化道出血事件。结论对于原发性血小板增多症合并冠心病行PCI患者,给予长期双联抗血小板治疗并合用羟基脲是安全有效的。

关键词(KeyWords)： 原发性血小板增多症;冠心病;经皮冠状动脉介入治疗

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 韩业晨,谢洪智,张抒扬

参考文献(References)：

• [1]Teff eri A,Barbui T.Polycythemia vera and essential thrombocythemia:2015 update on diagnosis,risk-stratifi cation and management.Am J Hematol,2015,90(2):162-173.
• [2]Rossi C,Randi ML,Zerbinati P,et al.Acute coronary disease in essential thrombocythemia and polycythemia vera.J Intern Med,1998,244(1):49-53.
• [3]Kasper DL,Braunwald E,Fauci AS,et al.Harrison's principles of internal medicine(17th ed.).New York:Mc Graw-Hill Medical Publishing Division,2008.
• [4]Carobbio A,Thiele J,Passamonti F,et al.Risk factors for arterial and venous thrombosis in WHO-defi ned essential thrombocythemia:an international study of 891 patients.Blood,2011,117(22):5857-5859.
• [5]Teff eri A.Mutant molecules of interest in myeloproliferative neoplasms:introduction.Acta Haematol,2008,119(4):192-193.
• [6]Pósfaié,Marton I,Kotosz B,et al.Contribution of cardiovascular risk factors in the thrombotic complications of essential thrombocythaemia:a Hungarian single-institute retrospective analysis.Eur Rev Med Pharmacol Sci,2015,19(7):1258-1263.
• [7]Cheng CW,Hung MJ.Coronary spasm-related acute myocardial infarction in a patient with essential thrombocythemia.World J Cardiol,2011,3(8):278-280.
• [8]Douste-Blazy P,Taudou MJ,Delay M,et al.Essential thrombocythaemia and recurrent myocardial infarction.Lancet,1984,2(8409):992.
• [9]Harrison CN,Bareford D,Butt N,et al.Guideline for investigation and management of adults and children presenting with a thrombocytosis.Br J Haematol,2010,149(3):352-375.
• [10]Xiong N,Gao W,Pan J,et al.Essential thrombocythemia presenting as acute coronary syndrome:case reports and literature review.J Thromb Thrombolysis,2017,44(1):57-62.
• [11]Tortorella G,Calzolari M,Tieghi A,et al.Acute coronary syndrome(ACS)in patients with essential thrombocytemia(ET).What is the best treatment?Int J Cardiol,2016,203:225-227.
• [12]杨旭,孙慧,邓丽,等.原发性血小板增多症合并心肌梗死10例.中国循环杂志,2016,31(2):119-121.