合并左眼视力丧失、后循环梗死的巨细胞动脉炎1例及文献复习

发布时间：2018-05-02 21:26

本文选题：巨细胞动脉炎 + 视力丧失　；参考：《卒中与神经疾病》2016年05期

【摘要】：目的探讨合并多种并发症的巨细胞动脉炎(Giant cell arteritis,GCA)患者临床特点。方法根据美国风湿病学学会(ACR)分类标准诊断一例合并左眼视力丧失及后循环梗死的巨细胞动脉炎患者,并复习相关国外文献进行分析。结果 86岁女性患者,双侧颞动脉增粗变硬,ESR108mm/h,颅脑MRI检查可见双侧小脑半球、脑干及右侧枕叶多发急性梗死灶,右侧椎动脉超声检查可见血管壁内膜均匀一致增厚,管腔向心性狭窄。最终诊断:(1)巨细胞动脉炎;(2)脑梗死;(3)左眼失明。结论 GCA最常累及颞动脉,其次是椎动脉、眼动脉及后睫状动脉,可引起视力丧失及后循环梗死等严重并发症。超声检查是明确诊断及评估治疗效果的有效手段。
[Abstract]:Objective to investigate the clinical features of Giant cell arteritis (GCA) patients with multiple complications. Methods A case of giant cell arteritis with left eye vision loss and posterior circulation infarction was diagnosed according to the ACR classification criteria of the American Society of Rheumatology. Results in 86-year-old female patients, bilateral temporal artery thickening and hardening (ESR 108mm / h), craniocerebral MRI examination showed multiple acute infarct foci in bilateral cerebellar hemisphere, brain stem and right occipital lobe. Concentric stenosis of the lumen. Final diagnosis: 1) giant cell arteritis 2) cerebral infarction 3) left eye blindness. Conclusion the temporal artery, vertebral artery, ophthalmic artery and posterior ciliary artery are the most frequently involved in GCA, which can cause serious complications such as visual loss and posterior circulation infarction. Ultrasonic examination is an effective method to diagnose and evaluate the therapeutic effect.
【作者单位】：武汉大学人民医院神经内科;
【基金】：湖北省卫计委重点项目(WJ2015MA007) 武汉市科技局2015年应用基础研究计划项目(2015060101010047) 国家自然科学基金资助项目(项目批准号为81301010)
【分类号】：R743

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