累及冠状动脉的多发性大动脉炎患者的临床特点与治疗对策的探讨
发布时间：2019-06-24 12:19
【摘要】：目的:初步探究累及冠状动脉的多发性大动脉炎(Takayasu arteritis,TA)患者的临床特点,试探讨累及冠状动脉的多发性大动脉炎患者的治疗对策方法:本研究采用回顾性病例研究的方法,收集自2003年7月至2015年6月期间于首都医科大学附属北京安贞医院内住院治疗的多发性大动脉炎患者的临床资料,建立资料库,选取合并冠状动脉疾病:心绞痛、心肌梗死或无症状冠状动脉狭窄、瘤样扩张的患者,根据“冠状动脉CTA及冠状动脉造影”对患者进行分类,收集患者相关临床治疗。利用统计软件进一步分析累及冠状动脉的多发性大动脉炎患者的客观数据(包括年龄、性别、家族史、治疗方式、手术情况、患病时间、一般症状、血管累及情况、冠状动脉受累情况、血清学检查、影像学检查等数据)探索多发性大动脉炎累及冠状动脉患者的临床特点以及治疗与管理。结果:此次研究共收集62例多发性大动脉炎累及冠状动脉患者资料,其中男性20例,女性42例,男女发病比为1:2.1。多发性大动脉炎累及冠状动脉患者组合并的心血管危险因素较少(p0.05)。44例患者初发症状为心绞痛。患有心肌梗死(急性及陈旧性心肌梗死)的患者有8例。心血管症状无明显差异(p0.05)共发现142处冠状动脉病变(单支狭窄大于50%)。开口处冠状动脉受累最为常见,高于普通冠心病患者(p0.05)。而在治疗上:共有33例患者接受了冠状动脉介入治疗。16名患者接受了手术血管旁路重建术。还有13例患者只接受了药物的保守治疗。远期随访中共发现再狭窄病例27人次,其中介入支架组出现再狭窄的患者共有11人(17人次),介入下单纯球囊扩张术组出现再狭窄的患者共有11人(13人次)。而对于冠状动脉搭桥组,出现再狭窄的患者共有5人(5人次)。介入治疗的再狭窄率高于冠状动脉搭桥术(p0.05)。结论:通过对我院多发性大动脉炎住院患者临床资料的回顾性分析,初步认为:多发性大动脉炎合并冠状动脉受累多见于青中年女性,平均年龄为45岁,多发性大动脉炎患者早期症状不具有特异性,以头痛、发热、乏力为最常见旨发症状。多发性大动脉炎的患者往往与常见的冠状动脉粥样硬化性心脏病的患者相比有较少的危险因素,而在冠状动脉病变引起的临床表现上没有明显区别。多发性大动脉炎多累及患者血管的开口部。关于冠脉病变的治疗上,血管内介入手术是最常用的手段,但术后再狭窄率较高。冠状动脉搭术较血管介入治疗再狭窄率明显下降。糖皮质激素和(或)细胞毒性药物可以降低血管内介入手术、外科手术的再狭窄率,可有效控制疾病活动、改善预后。
[Abstract]:Objective: to investigate the clinical characteristics of patients with Takayasu arteritis (Takayasu arteritis,TA) involving coronary artery, and to explore the treatment strategies of patients with Takayasu arteritis involved in coronary artery. The clinical data of patients with Takayasu arteritis hospitalized in Anzhen Hospital affiliated to Capital Medical University from July 2003 to June 2015 were collected. To establish a database of patients with coronary artery diseases: angina pectoris, myocardial infarction or asymptomatic coronary artery stenosis, tumor-like dilatation, according to the "coronary artery CTA and coronary angiography", the patients were classified, and the relevant clinical treatment of the patients was collected. The objective data (including age, sex, family history, treatment, operation, disease time, general symptoms, vascular involvement, coronary artery involvement, serological examination, imaging examination, etc.) were further analyzed by statistical software to explore the clinical characteristics, treatment and management of patients with Takayasu arteritis involved in coronary artery disease (including age, sex, family history, treatment, operation, disease time, general symptoms, vascular involvement, coronary artery involvement, serological examination, imaging examination, etc.). Results: a total of 62 patients with multiple arteritis involved in coronary artery were collected in this study, including 20 males and 42 females. The ratio of male to female was 1 鈮，
本文编号：2505058
[Abstract]:Objective: to investigate the clinical characteristics of patients with Takayasu arteritis (Takayasu arteritis,TA) involving coronary artery, and to explore the treatment strategies of patients with Takayasu arteritis involved in coronary artery. The clinical data of patients with Takayasu arteritis hospitalized in Anzhen Hospital affiliated to Capital Medical University from July 2003 to June 2015 were collected. To establish a database of patients with coronary artery diseases: angina pectoris, myocardial infarction or asymptomatic coronary artery stenosis, tumor-like dilatation, according to the "coronary artery CTA and coronary angiography", the patients were classified, and the relevant clinical treatment of the patients was collected. The objective data (including age, sex, family history, treatment, operation, disease time, general symptoms, vascular involvement, coronary artery involvement, serological examination, imaging examination, etc.) were further analyzed by statistical software to explore the clinical characteristics, treatment and management of patients with Takayasu arteritis involved in coronary artery disease (including age, sex, family history, treatment, operation, disease time, general symptoms, vascular involvement, coronary artery involvement, serological examination, imaging examination, etc.). Results: a total of 62 patients with multiple arteritis involved in coronary artery were collected in this study, including 20 males and 42 females. The ratio of male to female was 1 鈮，
本文编号：2505058
本文链接：https://www.wllwen.com/yixuelunwen/xxg/2505058.html
最近更新
教材专著
