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海德综合征:探索主动脉瓣狭窄与获得性出血性疾病之间的联系。

Heyde's syndrome: exploring the link between aortic stenosis and an acquired bleeding disorder.

作者信息

Ledingham David

机构信息

Department of Neurosciences, John Radcliffe Hospital, Oxford, Oxfordshire, UK.

出版信息

BMJ Case Rep. 2013 Apr 18;2013:bcr2013009306. doi: 10.1136/bcr-2013-009306.

Abstract

Heyde's syndrome was first proposed in 1958. It refers to gastrointestinal haemorrhage resulting from a combination of aortic stenosis with angiodysplasia. This report explores the case of a 93-year-old lady who was admitted to hospital following a neck of femur fracture. She suffered from multiple comorbidities including renal failure and congestive heart failure secondary to critical aortic stenosis. As an inpatient she suffered an exacerbation of both her heart and renal failure postoperatively. A week later she suffered from heavy upper gastro-intestinal bleeding, which failed to respond to pharmacological and endoscopic therapies as well as angiographic embolisation. The pathophysiology of Heyde's syndrome: an acquired von Willebrand deficiency syndrome has a much wider impact than was commonly thought, both in terms of how common it is and in how the association may be extrapolated to a wide range of bleeding disorders, rather than simply angiodysplasia associated gastrointestinal haemorrhage.

摘要

海德氏综合征于1958年首次被提出。它指的是主动脉瓣狭窄合并血管发育异常导致的胃肠道出血。本报告探讨了一名93岁女性的病例,该患者因股骨颈骨折入院。她患有多种合并症,包括继发于严重主动脉瓣狭窄的肾衰竭和充血性心力衰竭。住院期间,她术后出现心力衰竭和肾衰竭加重。一周后,她出现严重的上消化道出血,药物治疗、内镜治疗以及血管造影栓塞治疗均无效。海德氏综合征的病理生理学:获得性血管性血友病因子缺乏综合征的影响比通常认为的要广泛得多,无论是在其常见程度方面,还是在这种关联如何能外推至广泛的出血性疾病方面,而不仅仅是与血管发育异常相关的胃肠道出血。

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