扩张型心肌病患者栓塞发生机制及防治的研究进展

发布时间：2018-11-26 10:32

【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。
[Abstract]:The incidence of intracardiac thrombus and clinical thromboembolism were higher in patients with dilated cardiomyopathy (dilated cardiomyopathy,DCM). The formation of intracardiac thrombus is related to many factors, such as heart enlargement, endocardial changes, decreased myocardial movement, blood flow stagnation, arrhythmia, hypercoagulability and so on. At present, the expert advice for patients with dilated cardiomyopathy treated with anticoagulant is: left ventricular ejection fraction (left ventricular ejection fraction,LVEF) 30, have a history of embolism, or echocardiography found mural thrombosis. Patients with cardiac enlargement have been reported to have included aspirin or aspirin combined with hirudin as part of a routine regimen, while atrial fibrillation (atrial fibrillation,AF) was treated with warfarin or a new oral anticoagulant, (novel oral anticoagulants,NOACs. This article reviews the risk epidemiology, pathogenesis, prevention and treatment of embolism in patients with dilated cardiomyopathy.
【作者单位】：重庆医科大学附属第一医院心血管内科;
【基金】：重庆市卫生局科研资助项目(编号:2013-1-010)
【分类号】：R542.2

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