心脏瓣膜病介入治疗术后机械性溶血诊疗进展  

Advances in diagnosis and treatment of mechanical hemolysis following percutaneous interventional for valvular heart diseases

作　　者：奉伟庭 肖宜超[1] FENG Weiting;XIAO Yichao(Department of Cardiovascular Medicine,Second Xiangya Hospital,Central South University,Changsha 410011;Xiangya School of Medicine,Central South University,Changsha 410013,China)

机构地区：[1]中南大学湘雅二医院心血管内科,长沙410011 [2]中南大学湘雅医学院,长沙410013

出　　处：《中南大学学报（医学版）》2023年第9期1397-1402,共6页Journal of Central South University ：Medical Science

基　　金：国家自然科学基金(81700309)。

摘　　要：心脏瓣膜病是临床上常见的心脏病之一,其主要特征是瓣膜狭窄和/或关闭不全。目前药物治疗、外科手术和新兴的经皮介入治疗是心脏瓣膜病的主要治疗方法。虽然经皮介入治疗器械研发已相对成熟,但术后机械性溶血等问题仍然存在。机械性溶血的发生与红细胞所受的过度剪切应力、红细胞与心脏及瓣膜表面的直接作用和血栓形成等因素相关,并且术后感染和其他溶血性疾病也会造成机械性溶血的发生。虽然大多数患者发生溶血时无症状,但仍有危急重症情况的发生。这种溶血可加速病情的恶化,严重时甚至危及生命。阐述心脏瓣膜病经皮介入治疗术后机械性溶血的致病机制、流行病学以及相关临床研究进展对于指导该病的规范诊疗具有重要意义。Valvular heart disease is one of the common heart diseases in clinical practice,characterized by valve stenosis and/or incomplete closure.At present,drug therapy,surgery,and emerging percutaneous intervention therapy are the main treating methods for heart valve disease.Although the research and development of percutaneous intervention therapy devices is relatively mature,there are still problems such as postoperative mechanical hemolysis.The occurrence of mechanical hemolysis is associated with factors such as excessive shear stress experienced by red blood cells,direct interaction between red blood cells and the heart and valve surfaces,and thrombus formation.Furthermore,the presence of postoperative infection and other hemolytic diseases can also affect the occurrence of mechanical hemolysis.Although most patients are asymptomatic when hemolysis occurs,there are still critical cases.This type of hemolysis can accelerate the deterioration of the condition,and even endanger life in severe cases.Therefore,elucidating the background,pathogenesis,epidemiology,and related clinical research progress of mechanical hemolysis after percutaneous intervention therapy for valvular heart disease is of great significance for guiding the standardized diagnosis and treatment of the disease.

关 键 词：心脏瓣膜病 经皮介入治疗 机械性溶血 

分 类 号：R54[医药卫生—心血管疾病]