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Implantation of Total Artificial Heart in Congenital Heart Disease
Published on: July 18, 2014
シアノティック先天性心疾患を有する成人の脳卒中のリスク
J K Perloff1, A J Marelli, P D Miner
1Department of Medicine, University of California Los Angeles.
Circulation
|June 1, 1993
まとめ
フレボトミーは,脳卒中を予防するためにのみ,シアノティック先天性心疾患を有する成人に推奨されません. この研究では,これらの患者における高血圧値に関連した脳卒中リスクの証拠は見つかりませんでした.
科学分野:
- 心臓病学 心臓病学
- 神経学 神経学とは
- 血液学 ヘマトロジ
背景:
- シアノティック先天性心疾患の成人は,脳卒中のリスクが想定されていることから,高血球濃度のため,しばしばフレボトミーを受けます.
- ヘマトクリット,症状性赤血球症 (超粘性),および脳卒中との関係は,この集団におけるさらなる調査を必要としています.
研究 の 目的:
- シアノティック先天性心疾患の成人の高血圧値と症状性赤血球症が,脳動脈血栓性脳卒中のリスクの増加と相関するかどうかを判断する.
- この患者グループにおける脳卒中予防のためのフレボトミーの必要性を評価する.
主な方法:
- サイアノス性先天性心疾患を患った112人の成人を1〜12年間観察した遡及的研究.
- 患者は,血液濃度,鉄の状態,および高粘度症候群に基づいて,補償性および不補償性赤血球症のグループに分類されました.
- 排除基準には,栓塞性または血管縮性脳卒中の独立リスク要因が含まれていた.
主要な成果:
- ヘマトクリット値,鉄貯蔵量,または高粘度症候群に関係なく,完全な脳卒中 (脳梗塞による脳動脈血栓症) を発症した患者はいなかった.
- 補償された (血小数値46.0~72.7%) と解補償された (血小数値61.5~75.0%) 双方の赤血球細胞症群は,脳卒中への進行を示さなかった.
- フレボトミーによる鉄欠乏症は,健康に悪影響を及ぼす可能性があります.
結論:
- フレボトミーは,このリスクが実証されていないため,シアノティック先天性心疾患の患者の脳卒中リスクを軽減するために正当化されていません.
- フレボトミーは,重度の高粘度症候群の一時的な緩和のために考慮されてもよいが,血液濃度制御のためだけでは考慮されない.
- フレボトミーの一時的な循環効果と鉄欠乏のリスクは,この集団における脳卒中予防のために日常的に使用することを支持しません.
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