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在AL氨基粉症中抗肝素:一个病例报告

Elisabeth S van Ede¹, Marlijn P A Hoeks², Jan Hofland³

¹Department of Intensive Care Medicine, Radboudumc, Nijmegen, the Netherlands.

BMC anesthesiology

|June 21, 2023

概括

在心肺旁路 (CPB) 过程中,可以在不涉及抗素III (AT-III) 的情况下发生氨酸抵抗. 这一案例凸显了了解这种罕见的耐药性的重要性,并考虑直接的血栓抑制剂用于抗凝.

科学领域:

心血管外科心血管外科
血液学血液学血液学
麻醉学麻醉学

背景情况:

在心肺旁路 (CPB) 期间非抗素-III (AT-III) 介导的氨酸耐药性来自与氨酸结合蛋白的相互作用.
目前的临床指南缺乏具体的建议来管理这种类型的肝素耐药性.

研究的目的:

在心脏手术期间呈现耐火性肝素耐药性的病例.
强调识别和管理非AT-III介导的氨酸耐药性的重要性.

主要方法:

一个70岁的男性患者接受心脏手术的病例报告.
尸检以确定耐火性肝素耐药性的根本原因.

主要成果:

患者在CPB期间表现出耐火性肝素耐药性.
大规模的AL氨基粉症被确定为死后对肝素耐药性的可能原因.

结论:

对非AT-III介导的肝素耐药性病因的认识对于外科手术期间的管理至关重要.
可以考虑直接的血栓激素抑制剂 (例如,比瓦利鲁丁,阿格拉特罗班),因为它们绕过氨酸结合蛋白复合途径.

关键词:

在AL氨基粉症症.这是一种抗凝血药物.案例报告案例报告肝素耐药性肝素耐药性 perfusion 输液是一种输液.

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