广泛型大动脉炎伴双肾动脉狭窄并发心力衰竭1例  

Extensive Takayasu arteritis with bilateral renal artery stenosis complicated with heart failure—one case report

作　　者：耿明慧 张伟[2] 林海霞 姚述远[2] 干学东[2] 高苹[1] GENG Minghui;ZHANG Wei;LIN Haixia;YAO Shuyuan;GAN Xuedong;GAO Ping(Department of Nephrology,Zhongnan Hospital,Wuhan University,Wuhan,430071,China;Department of Cardiology,Zhongnan Hospital,Wuhan University)

机构地区：[1]武汉大学中南医院肾内科,武汉430071 [2]武汉大学中南医院心内科

出　　处：《临床心血管病杂志》2022年第5期423-426,共4页Journal of Clinical Cardiology

摘　　要：67岁的女性患者,诊断大动脉炎(TA),主要表现为心力衰竭、头晕、胸闷及严重的下肢高血压。双肾动脉重度狭窄引起的继发性高血压,因炎症同时累及双侧锁骨下动脉致双上肢血压假性正常而被掩盖。长期慢性肾血管性高血压引起的后负荷增加,加上炎症累及冠状动脉而加快了心力衰竭的进展。血管造影等证实了TA的诊断,经糖皮质激素、免疫抑制剂抗炎治疗,炎症指标恢复正常,后成功地实施了双肾动脉的介入治疗。The patient was a 67-year-old female with a diagnosis of Takayasu Arteritis(TA), which mainly presents with heart failure, dizziness, chest tightness, and severe lower extremity hypertension. Secondary hypertension caused by severe stenosis of both renal arteries, but was masked by pseudo-normal blood pressure in both upper extremities caused by simultaneous involvement of bilateral subclavian arteries by inflammation. Increased afterload from long-term chronic renovascular hypertension, coupled with inflammation involving coronary arteries, accelerates the progression of heart failure. Angiography confirmed the diagnosis of TA. After anti-inflammatory treatment with glucocorticoids and immunosuppressive agents, the inflammatory indexes returned to normal. Interventional therapy of both renal arteries was successfully performed.

关 键 词：大动脉炎 肾动脉狭窄 介入治疗 

分 类 号：R544.1[医药卫生—心血管疾病]