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人类免疫缺陷病毒患者的动脉血栓形成:两例报告及文献综述

Arterial thrombosis in patients with human immunodeficiency virus: two-case reports and review of the literature.

作者信息

Konin C, Anzouan-Kacou J B, Essam N'loo A

机构信息

Abidjan Cardiology Institute, BP 487, Abibjan 22, Cote D'Ivoire.

出版信息

Case Rep Vasc Med. 2011;2011:847241. doi: 10.1155/2011/847241. Epub 2011 Sep 12.

Abstract

Thrombosis during HIV infection was commonly vein thrombosis. Arterial thrombosis is also more and more described. We report two cases detected in the Abidjan Cardiology Institute. Case Reports. Case 1: an HIV infected female presented with sudden loss of consciousness and right hemiplegia. She had been taking HAART regimen for five years. Neck vessels ultrasonography revealed thrombosis on left ICA. Anticoagulant treatment leads to reduction of symptoms and left ICA partial recanalization. Case 2: male HIV infected taking HAART therapy was admitted for an acute pain of left lower limb; examination showed a decrease of heat, sensitivity, and mobility of this limb with popliteal and tibial pulses abolished. Arterial ultrasonography and CT angiography showed occlusion on the lower third of superficial femoral artery and homolateral popliteal artery suggesting a thrombosis of this artery. He underwent a femorotibial bypass surgery and anticoagulant treatment. The outcome was good with reappearance of local heat of the limb and tibial pulses. Probable etiology is early carotid atherosclerosis associated with protein S deficiency in the first case and antiphospholipid syndrome in the second case. Conclusion. Arterial thrombosis might occur in HIV infection. Several etiological factors could be involved in the pathogeny of these arterial thromboses.

摘要

HIV感染期间的血栓形成通常为静脉血栓形成。动脉血栓形成的报道也越来越多。我们报告在阿比让心脏病学研究所检测到的两例病例。病例报告。病例1:一名感染HIV的女性出现突然意识丧失和右侧偏瘫。她接受高效抗逆转录病毒治疗方案已五年。颈部血管超声检查显示左侧颈内动脉血栓形成。抗凝治疗使症状减轻,左侧颈内动脉部分再通。病例2:一名接受高效抗逆转录病毒治疗的感染HIV男性因左下肢急性疼痛入院;检查显示该肢体温度降低、感觉减退、活动度降低,腘动脉和胫后动脉搏动消失。动脉超声检查和CT血管造影显示股浅动脉下三分之一处和同侧腘动脉闭塞,提示该动脉血栓形成。他接受了股胫旁路手术和抗凝治疗。结果良好,肢体局部温度恢复,胫后动脉搏动重现。可能的病因在第一例中是早期颈动脉粥样硬化合并蛋白S缺乏,在第二例中是抗磷脂综合征。结论。HIV感染可能发生动脉血栓形成。这些动脉血栓形成的发病机制可能涉及多种病因。

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Management of HIV vasculopathy - a South African experience.HIV 血管病变的管理——南非的经验。
Eur J Vasc Endovasc Surg. 2010 Mar;39 Suppl 1:S25-31. doi: 10.1016/j.ejvs.2009.12.028. Epub 2010 Feb 26.
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[Antiphospholipid antibodies, antiphospholipid syndrome and viral infections].[抗磷脂抗体、抗磷脂综合征与病毒感染]
Rev Med Interne. 2009 Feb;30(2):135-41. doi: 10.1016/j.revmed.2008.05.020. Epub 2008 Oct 15.

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