共查询到20条相似文献,搜索用时 109 毫秒
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<正>患者男性,66岁。因"皮肤变红、瘙痒1年余,干咳、憋气、双下肢水肿10 d"于2013年5月21日入院。2012年初患者无诱因出现全身皮肤变红、增厚,伴瘙痒、脱屑,未诊治。2012年7月触及腋窝包块,最大直径4 cm,质韧,活动度可,无触痛。2012年10月因皮肤病变加重就诊我院,查血常规:白细胞计数11.18×109/L,嗜酸粒细胞(EOS)计数4.39×109/L,血红蛋白(HGB)113 g/L,血小板计数488×109/L;肝肾功能均正常,乳酸脱氢酶676 U/L;血沉22 mm/第1小 相似文献
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<正>患者女性,48岁。因反复憋气4个月,加重伴水肿2个月于2008年2月27日入院。患者于2007年11月10日无诱因出现憋气,持续肩背部疼痛9 h,外院行心电图(ECG):窦性心律(59次/min),Ⅱ、Ⅲ、aVF、V_1~V_4导联ST段弓背抬高(图1),血压85/53 mmHg,心肌酶升高,肌钙蛋白T阳性。诊断为急性心肌梗死(AMI),予组织型纤溶酶原激活物(r-tPA)50 mg静脉溶栓及抗缺血治疗后,症状减轻,心电图ST段稍有回落。3 d后复查ECC可见ST段明显回落(见图2)。接受冠心病二级预防用药。外院心肌酶谱升高持续数周。否认高血压和糖尿病史,否认高脂血症。闭经1个月,无吸烟史。查体:血压90/60 mm Hg,双肺呼吸音清,心音低 相似文献
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患者,男性,33岁,钻井工人。因胸闷、憋气伴心悸1个月余于1个月前(2006年4月24日)连续重体力劳动10h后突觉左侧胸闷、憋气及隐痛,同时伴心悸、面色苍白、虚汗及全身乏力,随即咯鲜血3口,无发热,无咳嗽、咳痰,无恶心、呕吐、反酸、嗳气,休息后症状缓解,持续约5min。此后胸闷、憋气间断发作,每于平地快步约50m时发生,休息后可缓解,每次持续数分钟,但咯血未再发生, 相似文献
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患者女性,36岁,因"胸闷3d、伴喘憋加重1d"于2013年1月19日入院.入院前3d患者无明显诱因出现胸闷,呈持续性,无胸痛,日常活动不受限.入院前ld患者活动后气短,逐渐加重出现喘憋,急来我院,查心电图:V1~4呈QS或rS,V1-2 ST段抬高0.1~0.2 mV,Ⅱ、aVF导联ST段压低0.05~0.1 mV(图1),此后观察无动态变化;心肌酶:肌酸激酶(CK) 1049 U/L,肌酸激酶同工酶(CK-MB) 145.1 μg/L,肌钙蛋白I(cTnI) 16.24 μg/L;N末端脑钠肽前体(NT-proBNP)9824 pg/ml.超声心动图:左心室舒张末径47 mm,室壁运动普遍减弱,射血分数(EF)31%,肺动脉收缩压53 mm Hg.查体:血压106/60 mm Hg,双肺可闻及哮鸣音,未触及明显心尖搏动,心率144次/min,各瓣膜听诊区未闻及病理性心杂音,腹软,无腹胀,肝脾肋下未触及,移动性浊音(-),肠鸣音正常,四肢无水肿.既往无高血压、高脂血症、糖尿病. 相似文献
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《The Egyptian Rheumatologist》2020,42(4):329-332
IntroductionCoincidence of ankylosing spondylitis (AS) and Takayasu arteritis (TA) in single person especially women is rare.Case reportWe report a 31 year old Iranian woman with AS from 5 years and giving history of inflammatory low back pain, morning stiffness, bilateral sacroiliac tenderness, positive Schöber test and enthesitis, negative human leucocytic antigen (HLA-B27) and sacroiliitis on plain X-ray. The patient was under treatment. After 2 years she returned with increased back, hip and entheseal pain as well as claudications in left hand during the eighth week of gestation in her first pregnancy. She discontinued the non-steroidal anti-inflammatory drugs three months before pregnancy and on examination was pulseless on the left side. Color Doppler studies showed segmental stenosis and increased intima thickness in subclavian, axillary and proximal brachial arteries of the left hand with reduced blood flow in those arteries. The right hand was normal. Laboratory result showed microcytic anemia (hemoglobin = 10.8 g/dl, mean corpuscular volume = 66 fL) and erythrocyte sedimentation rate = 104/1st hour. The findings were indicative of TA and she was treated with prednisolone and azathioprine and had successful delivery to full term normal boy at 39th week gestation by Caeserian section. She was followed for two more months after delivery with no complications.ConclusionBoth TA and AS have no significant adverse effects on pregnancy if diagnosed and timely treated properly. When they occur concomitantly, more attention and care is needed to prevent complications. 相似文献
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Takayasu arteritis is a chronic inflammatory large vessel vasculitis affecting the aorta and its main branches. It can present in various forms, and thereby may lead to a delay in diagnosis. We present a patient with Takayasu arteritis, diagnosed at our center when she presented with severe aortic regurgitation. We also review the current knowledge base with respect to Takayasu arteritis. 相似文献
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Nedaa Skeik Alexander J. Rodriguez Bjorn Engstrom 《The International journal of angiology》2015,24(3):244-248
Takayasu arteritis is a rare, chronic large vessel vasculitis that primarily affects women aged 10 to 40 years of Asian descent. The inflammatory processes of the disease can result in stenosis and/or occlusion of the aorta and its branches, causing a wide range of symptoms. Rarely, damage of the elastic lamina or muscular media can cause aneurysmal dilation of the affected vessel. Diagnosis is based on the clinical presentation, laboratory proof of inflammation, and imaging finding of wall thickening in the acute phase and later arterial stenosis or occlusion. Management includes disease control with immunosuppression and some patients might require revascularization. Here, we present a rare case of Takayasu arteritis with both right common carotid artery aneurysmal dilation and stenosis at a conforming site. Although aneurysmal dilation has been sparsely reported in the Takayasu arteritis literature, our case may represent the distinct finding of concomitant dilation and stenosis in this disease. 相似文献
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Sarcoidosis with Takayasu arteritis: a model of overlapping granulomatosis. A report of seven cases and literature review
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Catherine Chapelon‐Abric David Saadoun Isabelle Marie Cloé Comarmond Anne Claire Desbois Fanny Domont Léa Savey Patrice Cacoub 《International journal of rheumatic diseases》2018,21(3):740-745
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Vimal Mehta Bhagya Narayan Pandit Jamal Yusuf Saibal Mukhopadhyay Jagdeep Yadav Vijay Trehan Sanjay Tyagi 《Indian heart journal》2014,66(3):350-354
Balloon angioplasty of the stenosed aorta is usually a relatively simple, yet potentially a catastrophic procedure. Aortic rupture during aortoplasty, though uncommon, carries a high mortality. We report case of a 39-year-old female with aortoarteritis with multiple arterial stenoses whose infra-renal abdominal aorta ruptured during balloon dilatation of the stent deployed in that segment. The site of aortic rupture was temporarily occluded by low-pressure inflation of the same balloon and then was sealed using a stent-graft introduced by contra-lateral femoral arterial access. 相似文献
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目的 :探讨大动脉炎的血管造影诊断与介入治疗价值。方法 :大动脉炎 38例 ,男性 11例 ,女性 2 7例 ,年龄 8~ 5 4岁 ,平均 (30 5± 18)岁 ,均行血管造影检查。由 2名有经验的介入放射学医师按双盲法对其血管造影及介入治疗资料进行回顾性分析 ,然后共同讨论并达成一致意见。结果 :38例中 ,经血管造影按Lupi Herrera的综合分型法属Ⅰ型者 11例 ,Ⅱ型 15例 ,Ⅲ型 7例 ,Ⅳ型 5例。主要受累的动脉包括锁骨下动脉 2 0例 (5 2 6 % ) ,腹主动脉 15例 (39 5 % ) ,肾动脉 4例 (36 8% ) ,胸主动脉 10例(2 6 3% ) ,颈动脉 9例 (2 3 7% ) ,髂动脉 9例 (2 3 7% ) ,腋动脉 7例 (18 4 % ) ,肠系膜上动脉 4例 (10 5 % ) ,冠状动脉 3例 (7 9% ) ,肺动脉 3例 (7 9% )等。 2 2例行经皮腔内血管成形术和 12例行狭窄段支架置入术均获成功。结论 :血管造影有利于大动脉炎的临床诊断与指导治疗 ,血管内介入治疗是一种微创的疗效可靠的治疗手段。 相似文献
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Young-Bae Park Suk Keun Hong Kee Joon Choi Dae Won Sohn Byung Hee Oh Myoung Mook Lee Yun Shik Choi Jung Don Seo Young Woo Lee Jae Hyung Park 《Heart and vessels》1992,7(Z1):55-59
Clinical and angiographic features of Takayasu arteritis were investigated in 129 Korean patients. This disease affects females more frequently than males, in a ratio of 6.6 to 1. Of the total number of patients, 51 were in the third decade, 27 in the fourth decade, and 23 in the second decade. Common clinical symptoms were headache (60%), exertional dyspnea (42%), dizziness (36%), and malaise or weakness (34%). Takayasu arteritis affected the abdominal aorta (46%) and descending thoracic aorta (37%) more frequently than the ascending aorta (1%) and aortic arch (2%) According to Ueno's classification based on aortographic findings, the 129 patients were divided into type I (37), type II (25), and type III (67). Among the 48 patients who had coronary angiography, 11 (23%) showed coronary arterial involvement. Because the clinical features are determined by the extent and severity of the specific artery involved in the occlusive phase of the disease, total aortography including coronary angiography is very important in the initial evaluation of Takayasu arteritis. 相似文献
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《Seminars in arthritis and rheumatism》2016,45(6):724-728
ObjectiveTo compare clinical and imaging characteristics of patients with giant cell arteritis (GCA) and upper extremity (UE) arterial involvement to patients with Takayasu arteritis (TAK).MethodsA cohort of patients seen at the Mayo Clinic with TAK diagnosed between 1984 and 2009 and a cohort of patients with GCA and UE arterial involvement diagnosed between 1999 and 2008 were studied.ResultsThe TAK cohort consisted of 125 patients (91% female); the mean age (±SD) at diagnosis was 30.9 (±10) years. The cohort of patients with GCA and UE involvement comprised of 120 patients (80% female); the mean age (±SD) at diagnosis was 67.8 (±7.5) years. The mean time from onset of symptoms to diagnosis was significantly longer in TAK (3.2 years) than GCA (0.5 years), p < 0.001. UE claudication was reported in 40% with TAK and 53% with GCA, p = 0.04. UE blood pressure discrepancy was present in 65% with TAK versus 28% with GCA, p < 0.001. Involvement of the thoracic aorta, abdominal aorta, carotid arteries, innominate artery, mesenteric artery, and left renal artery was more frequently observed in TAK (p < 0.05). Among patients with luminal changes of the thoracic aorta, stenotic/occlusive lesions were predominant in TAK (81% compared to 0% in GCA), whereas aneurysmal disease was more common in GCA (100% compared with 19% in TAK, p < 0.001).ConclusionPatients with GCA and UE involvement differ from patients with TAK in clinical and imaging characteristics. Aortic aneurysms were more common in GCA, while stenotic changes of the aorta were more common in TAK, suggesting different pathophysiologic mechanisms or vascular response to injury. 相似文献