Concurrent pulmonary thrombosis with systemic embolism: a case report
Concurrent pulmonary thrombosis with systemic embolism: a case report
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肺血栓并发全身性栓塞：一例报告
DOI：
10.1631/jzus.b1400209
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发表时间：
2014
影响因子：
5.1
通讯作者：
Jian
中科院分区：
文献类型：
--
作者：
Xiao;Ju;Jun Jiang;Jian
Based on different mechanisms of blood coagulation, coexistence of venous thromboembolism and arterial thrombosis in a single individual is extremely rare in clinical practice. Both antiplatelet and anticoagulation therapy should be adopted for patients with arteriovenous embolism. Balancing the risk of ischemia and hemorrhage is especially challenging in these patients in order to achieve an optimal clinical benefit. We report on a 55-year-old female with acute pulmonary embolism (PE), subsequently diagnosed as having acute myocardial infarction (AMI) and a cerebral infarction. Examinations had been carried out, excluding potential arteriovenous shunts, cancer, antiphospholipid syndrome and other common hypercoagulable states. A combination of an anticoagulant drug (rivaroxaban, an Xa inhibitor) and an antiplatelet agent (clopidogrel, an ADP receptor inhibitor) was prescribed with a β-blocker and atorvastatin. The embolus was gradually shrunk during the next 10 months, and then it turned back into expanding. During the 16 months’ follow-up, an aneurysm of left ventricular apex was found through an echocardiogram and an angiotensin-converting enzyme inhibitor was administered. We conclude that combined anticoagulation and antiplatelet therapy significantly relieved the symptoms and improved the prognosis in patients suffering from arteriovenous embolism without any major clinical bleeding events.概要研究目的通过一例罕见肺栓塞合并体循环栓塞病例报道及定期随访, 为临床诊断思路和合理治疗方案的制定提供依据。研究方法本文报道一例在急诊室发生急性肺动脉栓塞, 后继又出现急性心肌梗死和脑梗塞的病例。 患者住院期间接受了严密监护并排除各种病因, 出院后随访16 个月, 动态观察肺动脉栓塞病情的进展和心脏重构的过程(如图3)。 结果显示, 早期溶栓治疗, 合理进行抗凝和抗血小板为主的综合治疗能显著缓解患者症状, 改善生活质量和预后。重要结论临床上动静脉系统同时发生栓塞虽然比较罕见, 但仍需提高警惕并及早诊断, 早期进行合理的治疗。 抗凝和抗血小板为主的联合治疗能显著改善症状, 提高患者生活质量, 改善预后。
特邀讲座：健康与疾病的电生理学
DOI：
--
发表时间：
2008
期刊：
影响因子：
--
作者：
金澤等;大波哲雄;吾妻翔太;武田沙也加;Moritani T
通讯作者：
Moritani T