在COVID-19相关的肺栓塞的抗凝固疗法期间,肝素诱导的血栓减小:一个病例报告
Yu Zhang1, Zhenling Chen, Jianying Li
1Civil Aviation General Hospital, Beijing, China.
Medicine
|December 10, 2024
概括
接受抗凝治疗的COVID-19患者可能会患上氨酸诱导的血小板缺血症 (HIT),这是一种严重的疾病,导致血小板减少和血栓形成. 及时诊断和切换到阿斯罗班对于康复至关重要.
科学领域:
- 内部医学 内部医学
- 血液学 血液学 血液学
- 关键护理医学 关键护理医学
背景情况:
- COVID-19与静脉血栓栓塞的高发病率有关,包括肺栓塞.
- 氨酸诱导的血小板缩 (HIT) 是对氨酸的危及生命的免疫反应,其特征是血小板缩和血栓形成.
- 在COVID-19相关的血栓栓塞事件的抗凝固疗法期间,HIT具有显著的风险.
研究的目的:
- 在COVID-19的老年患者中报告氨酸诱导的血小板缩 (HIT) 病例.
- 突出COVID-19治疗期间HIT的诊断挑战和管理.
- 强调在接受抗凝血剂的COVID-19患者中对HIT的警的重要性.
主要方法:
- 介绍了一个86岁的男性患有COVID-19的病例报告.
- 患者在纳德罗巴林治疗期间发展出血栓塞缩症和恶化的静脉血栓症.
- 4T评分被用于初步评估可疑的HIT.
主要成果:
- 在怀疑HIT时,停用了基于氨酸的抗凝药.
- 阿尔加特罗班最初用于抗凝血.
- 患者的血小板计数正常化,表明成功管理.
结论:
- 临床医生必须在COVID-19患者中保持对HIT的高度怀疑指数,即使在康复后.
- 早期识别和管理HIT,可能有助于抗体检测,对于预防严重后果至关重要.
- 未来对生物标志物的研究可能有助于识别患有HIT和相关血栓事件风险较高的患者.
相关概念视频
01:30Anticoagulant Drugs: Low-Molecular-Weight Heparins
616
Hemostasis is a crucial process that prevents excessive blood loss from damaged blood vessels. It involves various mechanisms such as vasoconstriction, platelet adhesion and activation, and fibrin formation. The importance of each mechanism depends on the type of vessel injury. In contrast, thrombosis is the abnormal formation of a blood clot within the blood vessels, leading to potential complications if the clot obstructs blood flow. Thrombosis can be caused by increased coagulability of the...
616
01:24Disorders of Hemostasis
707
Hemostasis, the process that stops bleeding after a blood vessel injury, is crucial for maintaining the integrity of the circulatory system. However, disorders of hemostasis can disrupt this delicate balance, leading to either excessive clotting or bleeding. These disorders can be broadly classified into thromboembolic disorders and bleeding disorders.
Thromboembolic Disorders
Two factors primarily cause thromboembolic conditions.
Thromboembolic Disorders
Two factors primarily cause thromboembolic conditions.
707
01:20Antiplatelet Drugs: Prostaglandin Synthesis, P2Y12 and Glycoprotein IIb/IIIa Inhibitors
468
Antiplatelet drugs emerge as frontline defenders against the insidious threat of thromboembolic diseases, where abnormal clots obstruct vital blood vessels. These drugs stand as bulwarks, inhibiting platelet aggregation and clot formation, thereby mitigating the risk of life-threatening conditions like myocardial infarction, coronary artery disease, and thrombotic strokes.
Prostaglandin synthesis inhibitors, exemplified by the widely known aspirin, wield their power by irreversibly acetylating...
Prostaglandin synthesis inhibitors, exemplified by the widely known aspirin, wield their power by irreversibly acetylating...
468
01:26Treatment for Pulmonary Arterial Hypertension: Receptor Tyrosine Kinase Inhibitors and Calcium Channel Blockers
141
Receptor tyrosine kinase inhibitors (TKIs) and calcium channel blockers (CCBs) are two critical categories of drugs employed in the treatment of pulmonary artery hypertension (PAH). PAH is a disease that causes high blood pressure in the pulmonary arteries, resulting in chest pain, fatigue, and shortness of breath.
TKIs, such as imatinib (Gleevec), are particularly effective in tackling the growth and mitogenic factors that become upregulated in PAH patients. These factors contribute to the...
TKIs, such as imatinib (Gleevec), are particularly effective in tackling the growth and mitogenic factors that become upregulated in PAH patients. These factors contribute to the...
141
01:23Treatment for Pulmonary Arterial Hypertension: Prostacyclin Receptor Agonists
147
Prostacyclin receptor agonists are a class of therapeutic agents integral to managing pulmonary arterial hypertension (PAH). These drugs operate by mimicking the action of prostaglandin I2, or PGI2, a naturally occurring compound in the body.
These agonists bind to the IPR receptor situated on the plasma membrane of the pulmonary artery smooth muscle cells. This binding triggers a cascade of reactions known as the GS-AC-cAMP-PKA pathway. This pathway results in the relaxation of smooth muscle...
These agonists bind to the IPR receptor situated on the plasma membrane of the pulmonary artery smooth muscle cells. This binding triggers a cascade of reactions known as the GS-AC-cAMP-PKA pathway. This pathway results in the relaxation of smooth muscle...
147
01:22Formation of the Platelet Plug
4.4K
The platelet phase, the second stage of hemostasis, commences around 15-20 seconds after an injury. It follows and overlaps with the vascular phase, during which blood vessels constrict to minimize blood loss.
As the injured blood vessel contracts, endothelial cells undergo contraction, revealing collagen fibers in the basement membrane and underlying connective tissue. Furthermore, the plasma membrane of endothelial cells becomes adhesive, preparing the site for platelet adhesion. Platelets...
As the injured blood vessel contracts, endothelial cells undergo contraction, revealing collagen fibers in the basement membrane and underlying connective tissue. Furthermore, the plasma membrane of endothelial cells becomes adhesive, preparing the site for platelet adhesion. Platelets...
4.4K