肺结核与静脉血栓栓塞症

Faouzia Kambouche, Labdouni Mohamed El Habib
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摘要

急性感染是静脉血栓栓塞症(VTE)的危险因素之一。慢性感染(如活动性肺结核)的作用尚不明确,但一些病例报告和系列病例表明肺结核与 VTE 之间存在联系。肺结核(TB)在发达国家的意外复发为评估 VTE 可能是肺结核并发症提供了依据;尽管如此,该主题在文献中却很少受到关注:这是一项前瞻性多中心研究,研究时间为 2016 年 1 月至 2018 年 1 月。患者和方法:这是一项前瞻性多中心研究,研究时间为 2016 年 1 月至 2018 年 1 月,研究对象为 17 例确诊肺结核伴有深静脉血栓形成的患者:其中男性 15 例,女性 2 例,平均年龄 44.88 岁。血栓栓塞并发症显示2名患者患有肺结核,在15名患者住院期间出现,其中11名患者正在接受抗结核药物治疗。我们列出了 3 例直接肺栓塞病例和 14 例深静脉血栓形成并发肺栓塞病例(7 例)。这些患者均按照 2RHZE / 4RH 方案接受了抗结核治疗,并接受了以低分子量肝素为基础的治疗性抗凝剂治疗。在 INR 控制令人满意后,开始使用维生素 K 拮抗剂进行中继治疗。有效抗凝时间平均为 15.12 天,最长为 08 至 50 天。结论:血栓栓塞(深静脉血栓)是一种常见的并发症:结论:肺结核患者必须系统地检查血栓栓塞(深静脉血栓)疾病,因为这种并发症的风险很高,尤其是在广泛和严重的情况下。预防性抗凝疗法适用于这些病例。
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Pulmonary tuberculosis and venous thromboembolism
Acute infections are among the risk factors for venous thromboembolism (VTE). The role of chronic infections such as active tuberculosis is poorly defined, although several case reports and case series have suggested a link association between tuberculosis and VTE. The unexpected resurgence of tuberculosis (TB) in developed countries provided the rationale for evaluating VTE as a possible complication of TB; never theless, the topic has received little attention in the literature. Patient and Method: This is a prospective multicenter study done between January 2016 and January 2018. It is about 17 cases of confirmed pulmonary tuberculosis associated with deep vein thrombosis. Results: It is about fifteen men and two women, their average age is 44,88 years. The thromboembolic complication revealed tuberculosis among 2patients, appearing during the hospitalization of 15 patients among which 11of them receiving antituberculosis drug. We have listed 3 cases of immediate pulmonary embolism and 14cases of deep vein thrombosis complicated with pulmonary embolism in 7 cases. These patients received anti-tuberculosis treatment according to the 2RHZE / 4RH protocol and a curative anticoagulant treatment based on low molecular weight heparin. A relay by vitamin K antagonists was instituted after a satisfactory INR control. The average time to effective anticoagulation was 15.12 days with extremes between 08 and 50 days. There was favorable evolution among 14 patients, 1of them was lost to follow-up. Sight and the evolution has been fatal in two case. Conclusion: Thromboembolic (DVT) disease must be sought systematically in the TB patients because of the risk of this complication particularly in extensive and severe forms. Prophylactic anticoagulation therapy finds its indications in these forms.
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