大动脉炎并发主动脉夹层临床特点分析

Clinical Feature Analysis in Patients of Takayasu's Arteritis Combined With Aortic Dissection

目的:探讨大动脉炎并发主动脉夹层的临床特点,为临床诊治提供参考。方法:回顾分析阜外心血管病医院2002-10至2011-08收治的5例大动脉炎并发主动脉夹层患者的临床资料,对其临床特征、影像特点及治疗情况进行总结。结果:5例患者均为女性,年龄中位数为39岁(18～46岁)。1例患者降主动脉内置入两枚支架,4例内科保守治疗。中位数随访时间2年(3个月～8.8年),所有患者夹层无进展,无肢体灌注不足及缺血性疼痛等临床症状。1例假腔减小,支架内血流通畅,无再发狭窄。1例因血压不能控制于2009年行腹主动脉人工血管置换术。2例假腔无明显变化。1例夹层愈合,假腔消失。结论:大动脉炎可并发主动脉夹层,病程隐匿,临床应予重视。

Objective：To explore the clinical features of Takayasu＇s arteritis combined with aortic dissection,and to provide the refe-rence in clinical practice. Methods：We retrospectively analyzed 5 patients of Takayasu＇s arteritis with aortic dissection who were treated in our hospital from 2002 to 2011.We collected the clinical information and summarized the characteristics,imaging records and treatment in all patients. Results：All 5 patients were female with the media age of 39 years,（18~46） years.1 patient received two stents implantation in descending aorta,and 4 had conservative treatment.The media follow-up time was 2 years,（3 months ~ 8.8 years）.There were no further development of the dissection,no hypo perfusion of limbs,and no ischemic pain in all 5 patients.1 patient had diminished false lumen,with in-stent smooth blood flow and without re-stenosis.1 patient underwent artificial blood vessel replacement of the abdominal aorta in 2009 because of uncontrolled hypertension.2 patients showed no progression in their dissection.1 patient had dissection sealed,and the false lumen disappeared. Conclusion： Takayasu＇s arteritis could combine with aortic dissection,the secretiveness of this disease should be highly alert in clinical practice.