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首页> 外文期刊>Journal of Clinical Medicine Research >Severe Gastrointestinal Bleeding in a Patient With Subvalvular Aortic Stenosis Treated With Thalidomide and Octreotide: Bridging to Transcoronary Ablation of Septal Hypertrophy
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Severe Gastrointestinal Bleeding in a Patient With Subvalvular Aortic Stenosis Treated With Thalidomide and Octreotide: Bridging to Transcoronary Ablation of Septal Hypertrophy

机译：沙利度胺和奥曲肽治疗患有主动脉瓣下狭窄的患者的严重胃肠道出血：桥接冠状动脉间隔间隔肥厚

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Gastrointestinal bleeding (GB) due to angiodysplasias can cause severe, recurrent bleeding, especially in elderly patients. Angiodysplastic bleedings in the gastrointestinal tract have been associated with aortic stenosis and, more recently, hypertrophic obstructive cardiomyopathy, caused by an acquired coagulopathy known as Heyde’s syndrome. Multiple factors are involved in the pathogenesis of angiodysplastic bleeding including genetic factors and increased levels of vascular intestinal growth factor at tissue levels. Endoscopic coagulation therapy is the primary treatment but often fails to resolve bleeding, especially in patients with large numbers of angiodysplasias. In patients with aortic stenosis and GB, the main treatment is aortic valve replacement but the patients may be unfit to undergo surgery due to the complicating anemia. In this case story, we present a patient with severe, GB due to hypertrophic subvalvular obstructive cardiomyopathy. Endoscopic procedures with argon beaming were performed without effect on bleeding. The patient was treated with a combination of both thalidomide and octreotide. Within 3 months, the patient recovered from the anemia and was able to undergo transcoronary ethanol ablation. No further bleeding episodes occurred, and thalidomide and octreotide were arrested. To our knowledge, this case report is the first to describe how this new drug combination therapy is an effective treatment of GB from angiodysplasias and can be used to bridge to surgical or endovascular treatment.J Clin Med Res. 2015;7(11):907-910doi: http://dx.doi.org/10.14740/jocmr2321w
机译：血管增生引起的胃肠道出血（GB）会引起严重的反复出血，尤其是在老年患者中。胃肠道血管增生性出血与主动脉瓣狭窄有关，最近与肥厚性阻塞性心肌病有关，后者是由获得性凝血病（称为海德氏综合症）引起的。血管增生性出血的发病机理涉及多种因素，包括遗传因素和组织水平血管肠生长因子水平的升高。内镜凝血治疗是主要治疗方法，但通常无法解决出血问题，尤其是在患有大量血管增生异常的患者中。对于患有主动脉瓣狭窄和GB的患者，主要治疗方法是主动脉瓣置换，但由于贫血的复杂性，患者可能不适合接受手术。在本案例中，我们介绍了由于肥厚性瓣膜下阻塞性心肌病而导致严重GB的患者。进行内镜下氩气照射对出血没有影响。该患者接受沙利度胺和奥曲肽的联合治疗。在3个月内，患者从贫血中康复，并且能够进行冠状动脉乙醇消融术。不再发生出血事件，沙利度胺和奥曲肽被捕。据我们所知，该病例报告是第一个描述这种新药联合疗法如何有效治疗血管增生引起的GB的方法，可用于桥接外科或血管内治疗。 2015; 7（11）：907-910doi：http：//dx.doi.org/10.14740/jocmr2321w

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