川崎病冠状动脉血栓形成发病机制及治疗进展
Progress in the mechanism and treatment of coronary artery thrombosis caused by Kawasaki disease
摘要川崎病并发冠状动脉血栓形成(coronary artery thrombosis,CAT)机制尚不明确,目前认为内皮细胞损伤、血液高凝状态以及冠状动脉扩张所致血流动力学改变是其主要原因。川崎病 CAT 急性期常无特异性临床表现,需积极行心脏超声监测,在血栓形成12 h 内或合并急性冠脉阻塞时需进行溶栓治疗,介入或静脉应用溶栓药物均有不同程度效果。血栓形成后慢性期应用阿司匹林联合华法林等口服药物可减少心肌梗死发生,提高远期存活率。在推荐剂量内使用溶栓及抗凝药物时较少发生不良反应,但仍需严密监测出血倾向。
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abstractsThe mechanism of coronary artery thrombosis(CAT)caused by Kawasaki disease is not clear yet.Endothelial injury,hypercoagulability and hemodynamic change of coronary arteries are now considered as the main causes in recent studies.As The clinical symptom of acute thrombus caused by Kawasaki disease is un-conspicuous,cardiac ultrasound should be use actively and thrombolytic therapy should be performed within 12 hours after thrombus formation or the onset of acute myocardial infarction.Intervention or intravenous thrombol-ysis are both proved to be effective.Treatment with oral antitplatelet drugs,such as aspirin,combine with warfa-rin is suggested to relieve acute myocardial infarction in the chronic phase.The adverse reactions of antithrom-botic and anticoagulant drugs should be monitored though they are minor.
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