Shim Byung-Ju, Youn Ho-Joong, Kim Yong-Chul, Kim Woo-Tae, Choi Yun-Seok, Lee Dong-Hyun, Park Chul- Soo, Oh Yong-Seok, Chung Wook-Sung, Kim Jae-Hyung, Choi Kyu-Bo, Hong Soon-Jo, Jung Seung-Eun, Hahn Seong-Tai
Division of Cardiology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea.
J Korean Med Sci. 2008 Jun;23(3):551-5. doi: 10.3346/jkms.2008.23.3.551.
A 17-yr-old young woman was referred to our hospital with a 2-yr history of claudication of the lower extremities and severe arterial hypertension. Physical examination revealed significantly different blood pressures between both arms (160/92 and 180/95 mmHg) and legs (92/61 and 82/57 mmHg). The hematological and biochemical values were within their normal ranges, except for the increased erythrocyte sedimentation rate (83 mm/hr) and C-reactive protein (6.19 mg/L). On 3-dimensional computed tomographic angiography, the ascending aorta, the aortic arch and its branches, and the thoracic and, descending aorta, but not the renal artery, were shown to be stenotic. The diagnosis of type IIb Takayasu's arteritis was made according to the new angiographic classification of Takayasu's arteritis, Takayasu conference 1994. Percutaneous transluminal angioplasty with stenting was performed on the thoracic and abdominal aorta. After the interventional procedures, the upper extremity blood pressure improved from 162/101 mmHg to 132/85 mmHg, respectively. She has been free of claudication and there have been no cardiac events during 2-yr of clinical follow-up.
一名17岁年轻女性因下肢间歇性跛行和严重动脉高血压病史2年转诊至我院。体格检查发现双臂血压(160/92和180/95 mmHg)与双腿血压(92/61和82/57 mmHg)存在显著差异。血液学和生化指标均在正常范围内,但红细胞沉降率(83 mm/hr)和C反应蛋白(6.19 mg/L)升高。三维计算机断层血管造影显示升主动脉、主动脉弓及其分支、胸主动脉和降主动脉狭窄,但肾动脉未受累。根据1994年Takayasu动脉炎会议的Takayasu动脉炎新血管造影分类,诊断为IIb型Takayasu动脉炎。对胸主动脉和腹主动脉进行了经皮腔内血管成形术并置入支架。介入治疗后,上肢血压分别从162/101 mmHg改善至132/85 mmHg。在2年的临床随访期间,她没有出现间歇性跛行,也没有发生心脏事件。