摘要
特发性血小板增多症（essential thrombocythemia, ET）是一种慢性骨髓增生性肿瘤，总体表现为不同形态学成熟度和造血效能的髓系细胞克隆性增生，特征为克隆性血小板过度生成，伴血栓形成和出血倾向。ET患者并发症和死亡的主要原因是血栓形成，包括静脉血栓形成（如深静脉血栓形成），以及动脉血栓形成（如脑血管事件、心肌梗死）。本文介绍了1例ET相关的急性心肌梗死的诊断和治疗过程。
关键词： 特发性血小板增多症；心肌梗死；血栓形成
Abstract
Essential thrombocythemia (ET) is a chronic myeloproliferative neoplasm characterized by the clonal proliferation of myeloid cells with varying degrees of maturation and hematopoietic efficiency, featuring the overproduction of clonal platelets, along with a propensity for thrombosis and bleeding. The leading cause of complications and mortality in ET patients is thrombosis, including venous thrombosis (such as deep vein thrombosis) and arterial thrombosis (such as cerebrovascular events, myocardial infarction). This article presents the diagnostic and therapeutic process of a case of acute myocardial infarction associated with ET.
Key words： Essential thrombocythemia; Myocardial infarction; Thrombosis
参考文献 References
[1] Baxter EJ, Scott LM, Campbell PJ, East C, Fourouclas N, Swanton S, Vassiliou GS, Bench AJ, Boyd EM, Curtin N, et al. Acquired mutation of the tyrosine kinase JAK2 in human myeloproliferative disorders. Lancet. 2005;365:1054-1061.
[2] Hobbs CM, Manning H, Bennett C, Vasquez L, Severin S, Brain L, Mazharian A, Guerrero JA, Li J, Soranzo N, et al. JAK2V617F leads to intrinsic changes in platelet formation and reactivity in a knock-in mouse model of essential thrombocythemia. Blood. 2013;122:3787-3797.
[3] Tefferi A, Fonseca R, Pereira DL, Hoagland HC. A long-term retrospective study of young women with essential thrombocythemia. Mayo Clin Proc. 2001;76:22-28.
[4] Gao W, Shen W, Luo X, Shi H, Jiang X, Pan J. ST-segment elevation myocardial infarction in patient with essential thrombocythemia without associated risk. Int J Cardiol. 2015;180:223-225.
[5] Tefferi A, Vannucchi AM, Barbui T. Essential thrombocythemia treatment algorithm 2018. Blood Cancer J. 2018;8:2.
[6] Rossi C, Randi ML, Zerbinati P, Rinaldi V, Girolami A. Acute coronary disease in essential thrombocythemia and polycythemia vera. J Intern Med. 1998;244:49-53.
[7] Tortorella G, Calzolari M, Tieghi A, Muia N, Piccin A, Gugliotta L. Acute coronary syndrome (ACS) in patients with essential thrombocytemia (ET). What is the best treatment? Int J Cardiol. 2016;203:225-227.
[8] Hernandez-Boluda JC, Alvarez-Larran A, Gomez M, Angona A, Amat P, Bellosillo B, Martinez-Aviles L, Navarro B, Teruel A, Martinez-Ruiz F, et al. Clinical evaluation of the European LeukaemiaNet criteria for clinicohaematological response and resistance/intolerance to hydroxycarbamide in essential thrombocythaemia. Br J Haematol. 2011;152:81-88.