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急性心肌梗塞在系統性紅斑性狼瘡合併抗磷脂抗體症候群與嚴重性血小板低下症-一病例報告暨文獻回溯

Acute Myocardial Infarction in Systemic Lupus Erythematosus with Antiphospholipid Syndrome and Severe Thrombocytopenia-A Case Report and Literature Review

摘要


傳統上非ST節段升高急性心肌梗塞的藥物治療有賴於使用抗血小板藥物及抗凝血劑的治療。但是在系統性紅斑性狼瘡的病患且合併有抗磷脂抗體症候群及嚴重性血小板低下症則會使心肌梗塞的治療更為困難。我們報告一個三十九歲紅斑性狼瘡女性發生急性心肌梗塞合併嚴重血小板低下症,在緊急給予靜脈內免疫球蛋白的治療而存活,且其冠狀動脈內血栓在經過三個月口服抗凝血劑後明顯消失。文中將針對紅斑性狼瘡合併抗磷脂抗體症候群之患者產生急性心肌梗塞之機轉,合併嚴重血小板低下症之緊急處理方式及長期血栓預防之藥物使用原則深入探討。

並列摘要


Traditional pharmacological therapy for non-ST elevation acute myocardial infarction (AMI) relies on the use of anticoagulants or glycoprotein Ⅱb Ⅲa antagonists. However, in patients with systemic lupus erythematosus combined with life-threatening idiopathic thrombocytopenia and antiphospholipid syndrome will make the acute myocardial infarction treatment more difficult. We report a 39 year-old female with SLE who had acute myocardial infarction and profound thrombocytopenia. She survived after emergent intravenous immunoglobulin infusion and the intracoronary thrombus significantly disappeared after treatment with three months oral anticoagulants.

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