Acute myocardial infarction in patients of nephrotic syndrome: a case series.
Acute myocardial infarction in patients of nephrotic syndrome: a case series.
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肾病综合征患者急性心肌梗死：病例系列
DOI：
10.11909/j.issn.1671-5411.2017.07.009
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发表时间：
2017-07
期刊：
影响因子：
--
通讯作者：
Gong JB
中科院分区：
文献类型：
--
作者：
Xie L;Tang Y;Liu J;He SQ;Li JH;Zhu Y;Liu ZB;Cheng Z;Gong JB
长期肾病综合征（NS）患者经常报告血栓栓塞并发症。虽然静脉系统血栓形成并发症在NS患者中很常见，但与NS相关的动脉血栓形成却不太常见。然而，冠状动脉血栓形成极为罕见。因此，NS是急性冠状动脉综合征（ACS）的罕见原因。因此，这些患者的发病率、发病机制和治疗尚未明确。在当前文献中，出版物包含的患者不到15例，其中大多数是幼儿。可观察到严重的凝血因子紊乱，如血小板功能亢进、血浆纤维蛋白原升高、纤溶系统异常和获得性凝血抑制剂缺乏。然而，血小板聚集增加和抗凝血酶III（AT III）缺乏是NS高凝状态中最重要的因素。NS中高凝状态的假设表明血栓栓塞与基础肾脏疾病（特别是微小病变肾小球病）之间存在临床相关性。慢性过量蛋白尿和长期暴露于止血和血脂异常的患者似乎有发生心血管疾病的高风险。本文对8例急性心肌梗死（AMI）患者的心电图、临床表现及心肌酶谱进行了分析。AMI前均诊断NS。据我们所知，这是第一个研究多例NS与AMI。在本病例研究中，本文介绍的病例是从金陵医院的数据库中回顾性收集的，
Thromboembolic complications have been frequently reported in patients with long-lasting nephrotic syndrome (NS). Although thrombotic complications in the venous system are common in patients with NS, arterial thromboses associated with NS are much less common. However, coronary thromboses are extremely rarely observed. So, NS is a rare cause of acute coronary syndrome (ACS). As such, the incidence, pathogenesis, and treatment of these patients have yet to be clearly defined. In the current literature, publications contain less than 15 patients, most of whom are young children. Serious clotting factor disturbances can be observed, such as changes in platelet hyperfunction, increased plasma fibrinogen, abnormalities of the fibrinolytic system, and acquired deficiencies of coagulation inhibitors. However, increased platelet aggregation and antithrombin III (AT III) deficiency are the most important factors in this hypercoagulable state in the NS. A hypothesis for hypercoagulable state in NS suggests a clinical correlation between thromboembolism and the underlying renal disease (especially minimal change glomerulopathy). Patients with chronic excess proteinuria and long-term exposure to abnormalities of hemostasis and lipid profiles appear to have a high risk of developing cardiovascular disease. In our study, we evaluated the characteristics of eight patients admitted to our hospital with a diagnosis of acute myocardial infarction (AMI) by ECG, clinical presentation and myocardial enzyme. They were all diagnosed NS before AMI. To our knowledge, this is the first study of multiple cases of NS associated with AMI. In this case study, the cases presented here were retrospectively collected from a database of Jinling Hospital in
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影响因子：
--
作者：
KENDALL, AG;LOHMANN, RC;DOSSETOR, JB
通讯作者：
DOSSETOR, JB
影响因子：
3.1
作者：
Manzar, KJ;Padder, FA;Jonas, EA
通讯作者：
Jonas, EA
影响因子：
5.1
作者：
FAHAL, IH;MCCLELLAND, P;BELL, GM
通讯作者：
BELL, GM
影响因子：
7.5
作者：
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通讯作者：
SILVER, MJ
影响因子：
3
作者：
HOPP, L;GILBOA, N;ORCHARD, TJ
通讯作者：
ORCHARD, TJ