多发性大动脉炎致心肌梗死一例  

Takayasu arteritis presenting with acute myocardial infarction: a case report

作　　者：马燕 陈丽星[2] 李兆武 周应秋[2] Ma Yan;Chen Lixing;Zhou Yingqiu;Li Zhaowu(Bonan Town Center Hospital, Yongping County, Dali Prefecture, Yunnan Province Dali 672603, China)

机构地区：[1]云南省大理州永平县博南镇中心卫生院,大理672603 [2]昆明医科大学第一附属医院心内科,昆明650000 [3]云南省大理州永平县妇幼保健计划生育服务中心,大理672600

出　　处：《新医学》2016年第10期718-720,共3页Journal of New Medicine

摘　　要：大动脉炎是一种少见的、系统性、慢性非特异性血管炎症，主要影响主动脉及其主要分支，大动脉炎累及冠状动脉的比例很高，约为1〇%~30%。该例女性患者因AMI人院，完善检查时发现全身多发血管病变，诊断为多发性大动脉炎，经免疫治疗好转。该例提示多发性大动脉炎由于发病隐匿，临床特征缺乏特异性，极易误诊。因此我们在临床工作中如遇到AMI的年轻女性患者，在无确切冠状动脉粥样硬化的危险因素下，体检如发现两上肢血压相差大于l〇mmHg、颈部、锁骨上或腹部闻及血管杂音、或有一侧或双侧肱动脉搏动减弱或消失，要想到多发性大动脉炎的可能，从而避免误诊、误治。Takayasu arteritis is arare,systemic, chronic and nonspecific inflammatory vasculitis affecting large vessels, predominantly the aorta and its main branches. The incidence of coronary involvement is relatively high up to approximately 10% to 30% . In this report, the female patient was hospitalized due to acute myocardial infarction and diagnosed with Takayasu arteritis because of systemic vascular lesions uponclinical examinations. She was gradually recovered after hormone therapy. This case hints that it is likely tomisdiagnose due to elusive onset and nonspecific symptoms of Takayasu arteritis. In clinical practice, the possibilityof Takayasu arteritis should be considered if blood pressure difference greater than 10 mmHg between both arms, murmur in neck and supraclavicular or abdomen and weakening or lack of pulse in unilateral or bilateral brachial artery were detected in young female patients with acute myocardial infarction without risk factors of coronary artery atherosclerosis, aiming to avert the incidence of misdiagnosis and treatment failure.

关 键 词：多发性大动脉炎 心肌梗死 

分 类 号：R542.22[医药卫生—心血管疾病] R543.5[医药卫生—内科学]