以AMI为首发表现的原发性抗磷脂综合征一例  

Antiphospholipid syndrome presented as acute myocardial infarction: a case report

作　　者：陈泽锋 税星[1] 陈璘[1] Chen Zefeng;Shui Xing;Chen Lin(Department of Cardiology,the Third Affiliated Hospital of Sun Yat-sen University,Guangzhou 510630,China)

机构地区：[1]中山大学附属第三医院心血管内科,广州510630

出　　处：《新医学》2020年第7期562-565,共4页Journal of New Medicine

摘　　要：抗磷脂综合征(APS)是一种自身免疫性疾病,其特征表现是抗磷脂抗体持续存在且合并血管血栓形成。该文报道一例以急性血栓形成致AMI为首发表现的APS患者的诊疗过程及随访情况。该患者无明显冠状动脉粥样硬化性心脏病(冠心病)危险因素,因发热查因入院,期间突发AMI,冠状动脉造影示右冠状动脉血栓形成,血栓抽吸后未植入支架。予抗凝抗血小板及抗风湿等治疗,10 d后复查冠状动脉造影未见明显异常。随访半年期间未再发血栓栓塞事件。该病例提示,对于冠状动脉造影以冠状动脉血栓形成为主且无明显冠心病危险因素的AMI患者,建议行APS筛查,以助于明确诊断及指导治疗。Antiphospholipid syndrome(APS) is an autoimmune syndrome characterized by persistent presence of antiphospholipid antibodies complicated with vascular thrombosis.In this article,we reported the diagnosis,treatment and follow-up of one case of APS presenting with acute myocardial infarction(AMI).The patient did not have significant risk factors of coronary heart disease and was admitted to our hospital because of fever of unknown origin.During hospitalization,the patient suddenly developed AMI.Coronary angiography revealed thombosis in the right coronary artery,and no coronary stent was implanted after thrombus aspiration.After antithrombotic and antirheumatic therapy for 10 days,coronary angiography revealed no thombosis or stenosis in the right coronary artery.No arterial or venous thrombosis events were found during the follow-up period.This case suggests that screening of APS is recommended for AMI patients presenting with coronary arterial thrombosis while without significant risk factors of coronary heart disease,which contributes to confirming the diagnosis and offering guidance on treatment.

关 键 词：抗磷脂综合征 冠状动脉血栓栓塞 急性心肌梗死 

分 类 号：R593.2[医药卫生—内科学]