老年髂动脉多发炎性动脉瘤的临床特点分析  

Clinical features of multiple inflammatory abdominal aortic aneurysm originating from iliac artery in an elderly patient

作　　者：吴雪萍[1] 樊瑾[1] 曹剑[1] 朱剑[2] 朱平[1] 郭伟[3] 

机构地区：[1]解放军总医院南楼心血管一科,北京100853 [2]解放军总医院风湿科,北京100853 [3]解放军总医院血管外科,北京100853

出　　处：《中华老年心脑血管病杂志》2012年第6期603-605,共3页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

摘　　要：目的了解髂动脉多发炎性腹主动脉瘤的临床特点,提高对本病诊断及药物治疗的认识。方法对1例发生于髂动脉的炎性腹主动脉瘤老年患者的临床资料进行分析,并复习有关文献。结果炎性腹主动脉瘤好发于70岁左右老年人,临床表现为突发腹痛或背痛,体重下降,C反应蛋白和红细胞沉降率升高,影像学检查可见动脉瘤壁增厚,炎症累及输尿管可引起肾盂积水,常规治疗需手术,早期经糖皮质激素及免疫抑制剂联合治疗可避免或推迟手术。结论突发严重腹痛的腹主动脉瘤患者,应尽早行影像学检查,发现动脉瘤壁增厚及肾盂积水支持本病诊断。早期糖皮质激素及免疫抑制剂治疗能显著缓解症状,并消除尿路梗阻。Objective To improve the understanding of multiple inflammatory abdominal aortic aneurysm originating from iliac artery and its drug therapy by investigating its clinical features. Methods Clinical data about an elderly patient with multiple inflammatory abdominal aortic aneurysm originating from iliac artery were analyzed with its related literature reviewed. Results Inflammatory abdominal aortic aneurysm usually occurred in elderly subjects aged about 70 years and was characterized by sudden abdominal or back pain,weight loss,increased C reactive protein and blood sedimentation level. CT and MRI showed thickened aneurysm wall with inflammation involving ureteral tract which could lead to hydronephorosis. It was usually treated by surgical resection. Early combined glucocorticoid and immunosuppressant therapy could avoid or delay its operation. Conclusion CT and MRI should be considered for abdominal aortic aneurysm patients with sudden severe abdominal pain. Thickened aneurysm wall and hydropherosis contribute to its diagnosis. Early combined glucocorticoid and immunosuppressant therapy can significantly alleviate its symptoms and ureteral tract obstruction.

关 键 词：髂动脉瘤 主动脉瘤 腹 腹痛 C反应蛋白质 早期诊断 药物疗法 免疫抑制剂 

分 类 号：R654.3[医药卫生—外科学]