抗磷脂抗体阳性Takayasu动脉炎1例临床分析及文献复习  

Antiphospholipid antibody-positive Takayasu arteritis:a case report and literature review

作　　者：王鼎鼎 吴浩文 孙淼鑫 柴文秀 李运霞 赵新成 李子薇 段丽萍[1] Wang Ding-ding;Wu Hao-wen;Sun Miao-xin;Chai Wen-xiu;Li Yun-xia;Zhao Xin-cheng;Li Zi-wei;Duan Li-ping(First Department of Nephropathy,Handan Central Hospital,Handan City Key Laboratory of Cardio-vascular and Cerebrovascular Diseases,Handan 056001,China)

机构地区：[1]邯郸市中心医院肾内一科,邯郸市心脑血管疾病重点实验室,邯郸056001

出　　处：《临床肾脏病杂志》2025年第3期201-207,共7页Journal Of Clinical Nephrology

摘　　要：目的 探讨抗磷脂抗体阳性Takayasu动脉炎(takayasu arteritis,TA)的临床特点,以提高临床医师对该疾病诊治的认识。方法 对1例表现为TA,同时抗磷脂酶抗体阳性患者的临床表现及影像学资料进行回顾性分析。以“多发性大动脉炎/takayasu arteritis”和“抗磷脂抗体/antibodies,antiphospholipid”或“抗磷脂综合征/antiphospholipid syndrome”为检索词在万方、维普、中国知网、PubMed数据库进行文献检索。结果 患者,男,41岁,间断腹痛伴意识不清就诊,影像学表现为全身多发大动脉狭窄、闭塞,临床合并心脑血管疾病、肾衰竭及感染,经抗炎、抗凝、激素、免疫抑制剂、免疫球蛋白及血浆置换等治疗预后仍差。经文献检索国外报道8例TA合并抗磷脂抗体阳性病例,年龄17~72岁,2例男性。除1例死亡外,7例经综合治疗使患者预后得到改善。结论 对于TA同时抗磷脂酶抗体阳性病例,早期诊断、全面评估、分层干预是诊治成功的关键。应提高临床医师早期诊断及鉴别诊断意识,规范抗凝及免疫抑制治疗,必要时介入及手术干预,以改善患者预后。Objective To investigate the clinical features of antiphospholipid antibody-positive Takayasu arteritis and to enhance the awareness of its diagnosis and treatment.Methods The clinical fea⁃tures and imaging data of one patient with antiphospholipid antibody-positive Takayasu arteritis were ret⁃rospectively analyzed.Literature review was performed by searching the keywords“Takayasu arteritis”and“antibodies,antiphospholipid”or“antiphospholipid syndrome”in databases such as Wanfang,VIP,China National Knowledge Infrastructure(CNKI),and PubMed.Results The 41 year-old male patient presented with intermittent abdominal pain and unconsciousness.The imaging findings showed multiple stenosis and occlusion of large arteries.The patient was combined with cardiovascular and cerebrovascu⁃lar disease,renal failure and infection.Despite the treatment of anti-inflammatory drugs,anticoagula⁃tion,hormones,immunosuppressive agents,immunoglobulin,and plasma exchange,the clinical out⁃come did not improve.Through literature review,8 cases of Takayasu arteritis with positive antiphospho⁃lipid antibodies,aged between 17 and 72 years were identified,including 2 males.Except for one death,the outcomes of the remaining 7 patients were improved through comprehensive treatment.Conclusion For patients with antiphospholipid antibody-positive Takayasu arteritis,early diagnosis,comprehensive evaluation,and stratified intervention are critical for successful diagnosis and treatment.Clinicians should enhance their awareness of early diagnosis and differential diagnosis,standardize anticoagulation and immunosuppressive therapy,and consider interventional and surgical treatment when necessary to improve the outcomes.

关 键 词：TAKAYASU动脉炎 抗磷脂抗体 抗磷脂综合征 

分 类 号：R73[医药卫生—肿瘤]