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免疫性血小板减少症(ITP)合并胸闷1例
引用本文:周鹏,郑杭萍,熊楠青,李念夷,王小钦,罗心平,李剑. 免疫性血小板减少症(ITP)合并胸闷1例[J]. 复旦学报(医学版), 2020, 47(4): 637-640. DOI: 10.3969/j.issn.1672-8467.2020.04.028
作者姓名:周鹏  郑杭萍  熊楠青  李念夷  王小钦  罗心平  李剑
作者单位:复旦大学附属华山医院心内科 上海 200040;复旦大学附属华山医院血液科 上海 200040
基金项目:上海市自然科学基金(17ZR1403700)
摘    要:免疫性血小板减少症(immune thrombocytopenia,ITP)是一种因免疫系统介导的血小板破坏过多进而导致血小板减少的疾病,具有高出血风险。冠心病(coronary artery disease,CAD)和经皮冠状动脉介入(percutaneous coronary intervention,PCI)术后的患者需要常规抗血小板治疗,与ITP的治疗相矛盾。本文报道1例ITP合并急性冠脉综合征(acute coronary syndrome,ACS)行PCI术的老年男性,因血小板数量低下、出血风险高而未行充分抗血小板治疗,导致ACS数次发作,于原冠脉支架内形成血栓,病程中数次行PCI术并调整抗血小板治疗方案和激素治疗剂量,以期为这类患者的临床处理提供参考。

关 键 词:免疫性血小板减少症(ITP)  冠心病(CAD)  急性冠脉综合征(ACS)  经皮冠状动脉介入(PCI)
收稿时间:2019-09-19

Immune thrombocytopenia(ITP)combined with chest tightness: a case report
ZHOU Peng,ZHENG Hang-ping,XIONG Nan-qing,LI Nian-yi,WANG Xiao-qin,LUO Xin-ping,LI Jian. Immune thrombocytopenia(ITP)combined with chest tightness: a case report[J]. Fudan University Journal of Medical Sciences, 2020, 47(4): 637-640. DOI: 10.3969/j.issn.1672-8467.2020.04.028
Authors:ZHOU Peng  ZHENG Hang-ping  XIONG Nan-qing  LI Nian-yi  WANG Xiao-qin  LUO Xin-ping  LI Jian
Affiliation:1.Department of Cardiology, Huashan Hospital, Fudan University, Shanghai 200040, China;2.Department of Hematology, Huashan Hospital, Fudan University, Shanghai 200040, China
Abstract:Immune thrombocytopenia(ITP)is a disease whose clinical feature is low platelet because of immunoreaction. ITP can result in high bleeding risk. However,patients with coronary artery disease (CAD)and percutaneous coronary intervention(PCI)need regular anti-platelet therapy.The treatments of ITP and CAD are contradictory.There is no standard therapy for patients with ITP and CAD.This paper reports an elderly male with ITP and acute coronary syndrome(ACS)who underwent PCI.Because of low platelet and high bleeding risk, the patient underwent several times of ACS.There was thrombogenesis in the previous stent after PCI.The patient underwent PCI and adjustment for anti-platelet therapy for several times.This case might provide some reference for clinical practice.
Keywords:immune thrombocytopenia(ITP)  coronary artery disease(CAD)  acute coronary syndrome(ACS)  percutaneous coronary intervention(PCI)  
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