抗磷脂综合征致冠状动脉非阻塞性心肌梗死1例
Myocardial Infarction with Non-Obstructive Coronary Artery Disease Caused by Antiphospholipid Syndrome: A Case Report
摘要: 约5%~10%的急性心肌梗死患者冠状动脉狭窄程度< 50%，临床上将其定义为冠状动脉非阻塞性心肌梗死(MINOCA)，冠状动脉血栓形成是其主要病因之一。该文报告1例抗磷脂综合征的青年男性患者发生冠状动脉血栓致急性下壁及后壁心肌梗死，冠状动脉造影显示右冠中远段及左室后支近段可见血栓，术后予以积极抗栓治疗。该文总结其可能病因、诊断依据及诊疗过程，以期为临床诊治类似病例提供参考。
Abstract: About 5%~10% of patients with acute myocardial infarction have coronary artery stenosis < 50%, which is clinically defined as myocardial infarction with non-obstructive coronary arteries (MINOCA). Coronary thrombosis is one of the main causes of MINOCA. This paper reports a case of acute inferior and posterior myocardial infarction caused by coronary thrombosis in a young male patient with antiphospholipid syndrome. Coronary angiography showed thrombosis in the middle and distal right coronary artery and proximal posterior branch of left ventricle. This article summa-rizes the possible etiology, diagnostic basis and diagnosis and treatment process, in order to pro-vide reference for clinical diagnosis and treatment of similar cases.
文章引用：伏林霞, 赵秋燕, 董榆, 刘钢. 抗磷脂综合征致冠状动脉非阻塞性心肌梗死1例[J]. 临床医学进展, 2022, 12(11): 10003-10007. https://doi.org/10.12677/ACM.2022.12111442

参考文献

[1] Agewall, S., Beltrame, J.F., Reynolds, H.R., et al. (2017) ESC Working Group Position Paper on Myocardial Infarction with Non-Obstructive Coronary Arteries. European Heart Journal, 38, 143-153.
[2] Lindahl, B., Baron, T., Albertucci, M., et al. (2021) Myocardial Infarction with Non-Obstructive Coronary Artery Disease. EuroIntervention: Journal of EuroPCR in Collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology, 17, e875-e887. [Google Scholar] [CrossRef] 
[3] Thygesen, K., Alpert, J.S., Jaffe, A.S., et al. (2018) Fourth Universal Definition of Myocardial Infarction (2018). Circulation, 138, e618-e651. [Google Scholar] [CrossRef] 
[4] Tamis-Holland, J.E., Jneid, H., Reynolds, H.R., et al. (2019) Contemporary Diagnosis and Management of Patients with Myocardial Infarction in the Absence of Obstructive Coro-nary Artery Disease: A Scientific Statement from the American Heart Association. Circulation, 139, e891-e908. [Google Scholar] [CrossRef] 
[5] Garcia, D. and Erkan, D. (2018) Diagnosis and Management of the Antiphospholipid Syndrome. The New England Journal of Medicine, 379, 1289-1290. [Google Scholar] [CrossRef] 
[6] Kolitz, T., Shiber, S., Sharabi, I., et al. (2019) Cardiac Manifesta-tions of Antiphospholipid Syndrome with Focus on Its Primary Form. Frontiers in Immunology, 10, Article No. 941. [Google Scholar] [CrossRef] [PubMed]
[7] Miyakis, S., Lockshin, M.D., Atsumi, T., et al. (2006) Internation-al Consensus Statement on an Update of the Classification Criteria for Definite Antiphospholipid Syndrome (APS). Journal of Thrombosis and Haemostasis: JTH, 4, 295-306. [Google Scholar] [CrossRef] [PubMed]
[8] 赵久良, 沈海丽, 柴克霞, 等. 抗磷脂综合征诊疗规范[J]. 中华内科杂志, 2022, 61(9): 1000-1007.
[9] Radin, M., Sciascia, S., Erkan, D., et al. (2019) The Adjusted Global Antiphospholipid Syndrome Score (aGAPSS) and the Risk of Recurrent Thrombosis: Results from the APS Action Cohort. Seminars in Arthritis and Rheumatism, 49, 464-468. [Google Scholar] [CrossRef] [PubMed]
[10] Tektonidou, M.G., Andreoli, L., Limper, M., et al. (2019) EULAR Recommendations for the Management of Antiphospholipid Syndrome in Adults. Annals of the Rheumatic Diseases, 78, 1296-1304. [Google Scholar] [CrossRef] [PubMed]
[11] Pengo, V., Denas, G., Zoppellaro, G., et al. (2018) Riva-roxaban vs Warfarin in High-Risk Patients with Antiphospholipid Syndrome. Blood, 132, 1365-1371. [Google Scholar] [CrossRef] [PubMed]
[12] 史晓敏, 龚岩, 胡箫笛, 等. 抗磷脂抗体升高与住院患者院内血栓形成的相关性研究[J]. 中华预防医学杂志, 2021, 55(9): 1100-1104.
[13] 岳芳, 杨海珍, 胡克. 阻塞性睡眠呼吸暂停与静脉血栓栓塞症相关性研究现状[J]. 国际呼吸杂志, 2022, 42(3): 161-167.
[14] 中国研究型医院学会血栓与止血专委会. 活化部分凝血活酶时间延长混合血浆纠正试验操作流程及结果解读中国专家共识[J]. 中华检验医学杂志, 2021, 44(8): 690-697.
[15] 中华医学会风湿病学分会. 抗磷脂综合征诊断和治疗指南[J]. 中华风湿病学杂志, 2011, 15(6): 407-410.

为你推荐