发性淋巴细胞性心肌炎成功通过大动脉内气球和体外膜氧化治疗得到控制:一个病例报告
Suélisson da Silva Araujo1, Izadora Raduan Brigo1, Leopoldo Fernando Moura Campos Angerami1
1Emergency Department, Heart Institute (InCor), Hospital das Clínicas, Faculty of Medicine, University of São Paulo, São Paulo, SP, Brazil.
The American journal of case reports
|November 1, 2023
概括
引起心脏性休克的发性淋巴细胞性心肌炎 (LM) 可以成功治疗. 结合动脉内气球 (IABP) 和静脉外体膜氧化 (V-A ECMO) 提供了这些关键患者的生存益处.
科学领域:
- 心脏病学 心脏病学
- 免疫学 免疫学 免疫学
- 关键护理医学 关键护理医学
背景情况:
- 淋巴细胞性心肌炎 (LM) 是一种罕见的心脏炎症疾病,表现不同.
- 爆发性LM可以导致严重的心脏性休克,通常需要机械循环支持.
- 目前对心脏性休克的 fulminant LM 的治疗方法包括内和辅助设备,如 IABP 和 V-A ECMO.
研究的目的:
- 报告一项成功的治疗 fulminant LM 与严重的心脏性休克.
- 评估IABP和V-A ECMO联合治疗在治疗 fulminant LM 的疗效.
- 为了突出这种联合机械支持策略的潜在生存益处.
主要方法:
- 一个32岁的妇女的病例报告,患有暴发性LM和心脏性休克.
- 开始使用血管活性药物,动脉内气球 (IABP) 和静脉外体膜氧化 (V-A ECMO).
- 脉冲甲基普雷迪尼索隆和静脉注射人类免疫球蛋白的使用,通过心脏内膜活检 (EMB) 得到证实.
主要成果:
- 患者出现胸痛,心电图异常,心脏生物标志物升高,LVEF严重降低 (25%).
- 心脏性休克需要IABP和V-A ECMO的联合支持.
- 在治疗后,患者呈现逐渐的临床改善,LVEF在出院时恢复到55%.
结论:
- Fulminant LM 是一种罕见但危及生命的疾病,需要立即介入.
- 同时使用IABP和V-A ECMO可能会改善LM诱导心脏病性休克患者的存活率.
- 这一案例证明了使用联合机械循环支持的重度 fulminant LM 的成功管理.
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