CAJ | 학술논문

目的：探讨强直性脊柱炎( ankylosing spondylitis, AS)合并大动脉炎( takayasu arteritis, TA)的临床特点,以减少误诊误治。方法回顾性分析1例AS合并TA患者的临床资料,并复习相关文献。结果①本例为25岁青年男性,有AS病史5年,在外院诊治过程中先后出现肺部感染、心力衰竭等,给予相应治疗效果欠佳,转我院。经详细查体,发现左侧桡动脉搏动减弱,双上肢血压差较大,颈部及左锁骨下闻及血管杂音,炎性指标升高,结合颈部磁共振动脉造影及全主动脉计算机体层摄影血管成像结果,补充诊断TA。予糖皮质激素联合环磷酰胺治疗,病情明显改善。②在PubMed、维普科技期刊数据库,以AS+TA为检索式,共命中7篇相关文献累计患者12例,以HLA-B27阳性者居多,均先诊断AS,多年后发现合并TA,炎性指标均升高,均有血管杂音。结论当AS患者出现发热、血管杂音、无脉时,应警惕是否合并TA。 AS与TA是否具有遗传易感性尚有待进一步研究。
목적：탐토강직성척주염( ankylosing spondylitis, AS)합병대동맥염( takayasu arteritis, TA)적림상특점,이감소오진오치。방법회고성분석1례AS합병TA환자적림상자료,병복습상관문헌。결과①본례위25세청년남성,유AS병사5년,재외원진치과정중선후출현폐부감염、심력쇠갈등,급여상응치료효과흠가,전아원。경상세사체,발현좌측뇨동맥박동감약,쌍상지혈압차교대,경부급좌쇄골하문급혈관잡음,염성지표승고,결합경부자공진동맥조영급전주동맥계산궤체층섭영혈관성상결과,보충진단TA。여당피질격소연합배린선알치료,병정명현개선。②재PubMed、유보과기기간수거고,이AS+TA위검색식,공명중7편상관문헌루계환자12례,이HLA-B27양성자거다,균선진단AS,다년후발현합병TA,염성지표균승고,균유혈관잡음。결론당AS환자출현발열、혈관잡음、무맥시,응경척시부합병TA。 AS여TA시부구유유전역감성상유대진일보연구。
Objective To investigate the clinical characteristics of the ankylosing spondylitis ( AS) with takayasu ar-teritis ( TA) so as to reduce misdiagnosis rate. Methods Retrospective analysis on clinical data of one case of AS merged with TA was made and the literature was reviewed. Results ① The 25-year-old male patient had a 5-year history of AS and suffered pulmonary infection and heart failure. The patient was transferred to our hospital after corresponding treatment with poor effect. With detailed examinations, relit radial pulse was found weaker and significant difference of the upper limbs blood pressure, vascular murmur of neck and left infraclavicula were found. Combined with carotid magnetic resonance angiography, additional diagnosis was made to confirm TA. After corticosteroids and cyclophosphamide treatment, the condition improved obviously. ②In PubMed and Cqvip periodical database, using AS+TA as the retrieval, 7 articles were hit with an accumula-tive total of 12 patients, mostly female, the majority of HLA-B27 was positive, occasionally negative. The 12 cases were first diagnosed as AS, and was later discovered to be merged with TA many years later, and inflammatory markers increased and vascular murmur was heard. Conclusion When the AS patients have fever, vascular murmur, pulseless, or no pulse, it should be taken as a warning that TA is merged. The association and coexistence of AS and TA are not accidental. However, it needs further study as to whether there is a genetic predisposition or not.