摘要
目的 探讨大动脉炎累及冠状动脉的临床特点及介入治疗效果.方法 回顾性分析北京协和医院2000至2013年住院的连续98例大动脉炎患者,经冠状动脉造影证实冠状动脉狭窄＞50％的病例,收集患者的症状、体征、实验室检查结果、冠状动脉造影结果、介入治疗经过及转归资料.结果 大动脉炎累及冠状动脉共6例,占同期住院大动脉炎患者的6.1％ （6/98）,均为女性,年龄15 ～51岁,平均年龄（32±14）岁.6例患者均有典型心绞痛发作,发作时心电图均为ST段水平型或下斜型压低,5例同时伴心肌酶升高,符合非ST段抬高型心肌梗死诊断标准.6例患者中4例有外周动脉病变的证据,其余2例仅有冠状动脉受累.冠状动脉造影可以明确诊断,最常见狭窄部位是冠状动脉开口.5例患者经皮冠状动脉介入治疗后心绞痛症状明显改善.但1例患者支架置入术后3个月出现支架内再狭窄.结论 大动脉炎累及冠状动脉多累及冠状动脉开口,临床多表现为非ST段抬高型心肌梗死,经皮冠状动脉介入治疗短期有效.
Objective To explore the clinical characteristics and efficacies of interventional therapy for coronary artery involvement in Takayasu＇ s arteritis （TA）.Methods A total of 98 consecutive hospitalized TA patients with more than 50% diameter reduction of coronary artery by angiography were retrospectively analyzed from 2000 to 2013 at Peking Union Medical College Hospital.Results Six cases（6/ 98,6.1%）had coronary artery involvement of TA.All were females with an age range of 15-51 （32 ± 16） years.The manifestations included typical angina pectoris with a depression of ST segment on electrocardiogram.Among them,myocardial enzyme elevated in 5 cases and fulfilled the diagnosis of non-ST elevated myocardial infarction.Four cases had peripheral arterial involvement while another 2 cases had only coronary involvement.Coronary angiography was useful for definitive diagnosis.Coronary ostia was the most frequently involved.Five patients received successful coronary revascularization with drug-eluting stent and the symptom of angina pectoris improved.However,1 patient developed restenosis in stent 3 months after percutaneous coronary intervention （PCI）.Conclusions Coronary artery involvement in TA is not rare,especially ostia.The patients usually present with non-ST elevated myocardial infarction.PCI with drug-eluting stent may improve the symptoms,but the long-term effect should be investigated further.
出处
《中华医学杂志》
CAS
CSCD
北大核心
2014年第24期1874-1877,共4页
National Medical Journal of China
关键词
动脉炎
冠状动脉疾病
心肌梗塞
Arteritis
Coronary artery disease
Myocardial infarction
