年轻女性大动脉炎致冠状动脉左主干病变1例  

Left main coronary artery disease caused by arteritis in a young woman

作　　者：宋学莲 王帆 高鹏 张飞飞[1] 党懿[1] 齐晓勇[1] SONG Xuelian;WANG Fan;GAO Peng;ZHANG Feifei;DANG Yi;QI Xiaoyong(Department of Cardiovascular Disease Center,Hebei General Hospital,Shijiazhuang,050000,China)

机构地区：[1]河北省人民医院心血管内科,石家庄050000

出　　处：《临床心血管病杂志》2023年第5期400-403,共4页Journal of Clinical Cardiology

基　　金：河北省医学科学研究课题计划(No:20220820)。

摘　　要：青年女性患者,16岁,主因胸闷、头痛4d入院,入院当天胸闷加重,活动耐量下降,并出现胸痛,心电图为aVR导联抬高,其余导联均显著压低。心脏彩超提示左室壁运动弥漫性减低。化验患者氧分压降低,肌钙蛋白、C反应蛋白、D二聚体定量、血沉均升高。冠脉造影提示左主干病变,于病变处植入1枚支架。后续完善检查,全身大动脉CT血管造影(computedtomographyangiography,CTA)显示肺动脉、肾动脉多处弥漫性管壁增厚、狭窄。患者符合大动脉炎诊断,给予激素+免疫抑制剂+托珠单抗治疗大动脉炎及冠脉介入后抗血小板、抗凝、抑制心室重塑、利尿减轻心脏负荷、抑酸护胃等综合治疗,患者病情好转出院。5个月随访患者无不适症状发作,心功能恢复,病情平稳。The patient,a 16-year-old young female,was admitted to the hospital mainly due to chest tightness and headache for 4 days.On the day of admission,the chest tightness worsened,activity tolerance decreased,and chest pain occurred.The electrocardiogram showed elevated aVR leads,and other leads were significantly depressed.Color echocardiography showed reduced diffusion of left ventricular wall motion.Oxygen partial pressure decreased,troponin,C-reactive protein,D dimer quantification,erythrocyte sedimentation rate increased.Coronary angiography indicated left main lesion,and a stent was implanted.Computed tomography angiography(CTA)showed diffuse wall thickening and stenosis in pulmonary and renal arteries.The patient was diagnosed with Takayasu arteritis,and prescribed hormone,immunosuppressant and tozimumab and a comprehensive treatment of anti-platelet,anticoagulation,inhibition of ventricular remodeling,diuresis to reduce cardiac load after coronary intervention.The patient recovered well in follow-up of 5 months.

关 键 词：大动脉炎 左主干病变 青年女性 

分 类 号：R544[医药卫生—心血管疾病]