白塞氏病累及冠状动脉患者六例临床特点分析-中国循环杂志.PDFVIP

中国循环杂志 2017 年 5 月 第 32 卷 第 5 期（总第 227 期）Chinese Circulation Journal，May，2017，Vol. 32 No.5（Serial No.227） 493 临床研究 白塞氏病累及冠状动脉患者六例临床特点分析 支爱华，戴汝平，蒋世良，吕滨 摘要 目的：探讨累及冠状动脉的白塞氏病患者的影像学特点，以期提高临床诊治。 方法：分析 1999-08 至 2016-11 在阜外医院诊治的 6 例白塞氏病冠状动脉受累患者的临床特点。采用冠状动脉 造影和（或 ）冠状动脉增强计算机体层摄影术血管造影（CTA）诊断。6 例中 5 例患者行冠状动脉造影检查，5 例行冠状 动脉 CTA 检查。 结果： 6 例白塞氏病患者累及冠状动脉首次均以突发心包填塞、心肌梗死或心原性休克就诊，影像学表现为冠状 动脉狭窄、闭塞及假性动脉瘤形成。累及前降支近中段 3 例，回旋支远段 1 例，右冠状动脉中段 2 例，均伴有大量 心包积液。治疗方面：3 例患者冠状动脉假性动脉瘤保守治疗（以为占位病变开胸探查手术 1 例 ），其中 1 例失访，2 例长期正常生活；3 例患者发病后行冠状动脉支架置入术，术后效果不佳。 结论：累及冠状动脉的白塞氏病患者易形成假性动脉瘤，通过冠状动脉造影和（或 ）冠状动脉 CTA 有助于诊断。 术前明确病因诊断对临床治疗方法选择有重要意义。 关键词 白塞氏病；冠状血管造影术；体层摄影术，X 线计算机 The Imaging and Clinical Feature Analysis for Behcet’s Disease With Coronary Artery Involvement in 6 Patients ZHI Ai-hua, DAI Ru-ping, JIANG Shi-liang, LV Bin. Department of Radiology, Cardiovascular Institute and Fu Wai Hospital, CAMS and PUMC, Beijing (100037), China Corresponding Author: ZHI Ai-hua, Email: zhiah@163.com Abstract Objective: To explore the imaging and clinical features of Behcet’s disease with coronary artery involvement in order to improve the diagnosis and treatment in clinical practice. Methods: A total of 6 Behcet’s disease patients with coronary involvement diagnosed and treated in our hospital from 1999-08 to 2016-11 were analyzed. Coronary angiography (CAG) and coronary CTA were performed for diagnosis. There were 5 cases received CAG and 5 cases received CTA examinations. Results: All 6 patients had the first clinical visit by sudden pericardial tapenade, myocardial infarction or cardiac shock. For diagnosis: the imaging presentation included coronary stenosis, occlusion and pseudo aneurysm formation. 3 patients had anterior descending artery involvement, 1 had the far-end of left circumflex i