蓝趾综合征1例报告及治疗分析  

Medical treatment of blue toe syndrome

作　　者：周斌[1] 刘彦君[2] 邹小蜂 陆祖谦[2] 许樟荣[2] 班绎娟 宁丹 王爱红[2] 

机构地区：[1]江苏大学附属武进医院内分泌科,江苏省常州市 [2]解放军第306医院内分泌科,北京市100101 [3]安徽省太和县中医院糖尿病科,安徽省阜阳市

出　　处：《北京医学》2016年第4期328-332,共5页Beijing Medical Journal

基　　金：军队临床高新技术重大项目(2010gxjs054);中华医学会临床医学科研专项资金项目(12020580358);首都临床特色应用研究项目(Z141107002514181)

摘　　要：目的总结蓝趾综合征内科治疗的临床经验。方法对1例蓝趾综合征患者的临床特征、鉴别诊断、治疗经过及随访资料进行分析。结果患者65岁,因左足第5趾肿痛、淤紫20d入院。既往有高血压病、2型糖尿病病史,足背动脉、胫后动脉搏动正常,D-二聚体、踝肱指数正常,下肢动脉CTA示双侧股动脉轻度狭窄。确诊为蓝趾综合征,给予积极抗凝、抗血小板、改善微循环等内科综合治疗,取得良好疗效。随访14个月无复发。结论蓝趾综合征患者的截肢和死亡风险较高,其早期识别、准确评估、治疗方案选择十分重要,动态观察临床表现、实验室指标是内科治疗成功的重要保证。Objective To summarize the medical treatment for blue toe syndrome. Methods We presented one case of blue toe syndrome. The clinical features, differential diagnosis, treatment procedure and follow-up data were analyzed. Results The current patient was 65 years old, complained of painful and purple left fifth toe for 20 days. He had a history of hypertension and type 2 diabetes, while his dorsalispedis artery and posterior tibial artery pulses were normal. Ddimer and ankle brachial index were also normal. Lower extremity arterial CTA showed mild stenosis of bilateral femoral artery. The patient was finally diagnosed as blue toe syndrome, and recovered markedly after treated with anticoagulants,antiplatelet drugs, and prostaglandin E-1. No recurrence occurred after followed-up for 14 months. Conclusion The risks of amputation and death are high in patients with blue toe syndrome, and therefore early identification, accurate evaluation and therapeutic scheme are critical. Dynamic observations of clinical manifestation and laboratory indicators are important to successful medical treatment.

关 键 词：蓝趾综合征 内科治疗 

分 类 号：R543[医药卫生—心血管疾病]