摘要
扩张型心肌病(dilated cardiomyopathy,DCM)患者心腔内血栓发生率及临床血栓栓塞事件发生率均较高。心腔内血栓形成与多种因素有关,如心脏扩大、心内膜面改变、心肌运动减弱、血流淤滞、心律失常、血液高凝状态等。目前针对扩张型心肌病患者加用抗凝剂治疗的专家建议是:左心室射血分数(left ventricular ejection fraction,LVEF)<30%,有栓塞表现的病史,或超声心动图发现附壁血栓形成。心脏扩大患者有报道把阿司匹林或阿司匹林联合水蛭素类药等纳入常规治疗方案,合并房颤(atrial fibrillation,AF)则加用华法林或新型口服抗凝药(novel oral anticoagulants,NOACs)治疗,本文仅对扩张型心肌病患者栓塞风险流行病学、发生机制和防治进行综述。
Patients with dilated cardiomyopathy（DCM）have higher incidence of heart lumen thrombosis and clinical thromboembolic events. Heart lumen thrombosis relates to many factors,including cardiac dilatation,the endocardial surface change,myocardial motion decreases,blood flow congestion,arrhythmia,blood high condensation state,etc. Now,the expert advice for adding anticoagulant therapy for patients with DCM is：left ventricular ejection fraction30%,having a history of embolism performance,or mural thrombus formation in echocardiography. There were articles reported using aspirin,or by a combination of aspirin and hirudin drugs as conventional treatment for patients with cardiomegaly;some reported adding warfarin or new oral anticoagulants if cardiomegaly complicated with atrial fibrillation. This article reviewed the epidemiology,mechanism and prevention and cure for risk patients with DCM.
作者
杨丽丽
张晓刚
Yang Lili Zhang Xiaogang(Department of Cardiovascular Diseases,The First Affiliated Hospital of Chongqing Medical Universit)
出处
《重庆医科大学学报》
CSCD
北大核心
2017年第5期613-617,共5页
Journal of Chongqing Medical University
基金
重庆市卫生局科研资助项目(编号:2013-1-010)
关键词
扩张型心肌病
血栓
栓塞
抗栓
dilated cardiomyopathy
blood clots
embolism
anti-thrombus
