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[大动脉炎冠状动脉受累的临床特征及介入治疗疗效]

[Clinical characteristics and efficiency of interventional therapy for coronary artery involvement in Takayasu's arteritis].

作者信息

Yang Ming, Zeng Yong, Shen Zhujun, Fang Quan

机构信息

Department of Cardiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China.

Department of Cardiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China. Email:

出版信息

Zhonghua Yi Xue Za Zhi. 2014 Jun 24;94(24):1874-7.

PMID:25154992
Abstract

OBJECTIVE

To explore the clinical characteristics and efficacies of interventional therapy for coronary artery involvement in Takayasu's arteritis (TA).

METHODS

A total of 98 consecutive hospitalized TA patients with more than 50% diameter reduction of coronary artery by angiography were retrospectively analyzed from 2000 to 2013 at Peking Union Medical College Hospital.

RESULTS

Six cases (6/98, 6.1%) had coronary artery involvement of TA. All were females with an age range of 15-51 (32 ± 16) years. The manifestations included typical angina pectoris with a depression of ST segment on electrocardiogram. Among them, myocardial enzyme elevated in 5 cases and fulfilled the diagnosis of non-ST elevated myocardial infarction.Four cases had peripheral arterial involvement while another 2 cases had only coronary involvement. Coronary angiography was useful for definitive diagnosis. Coronary ostia was the most frequently involved.Five patients received successful coronary revascularization with drug-eluting stent and the symptom of angina pectoris improved.However, 1 patient developed restenosis in stent 3 months after percutaneous coronary intervention (PCI).

CONCLUSIONS

Coronary artery involvement in TA is not rare, especially ostia. The patients usually present with non-ST elevated myocardial infarction. PCI with drug-eluting stent may improve the symptoms, but the long-term effect should be investigated further.

摘要

目的

探讨大动脉炎(TA)冠状动脉受累的临床特征及介入治疗疗效。

方法

回顾性分析2000年至2013年在北京协和医院住院的98例经血管造影显示冠状动脉直径缩小超过50%的连续性TA患者。

结果

98例患者中有6例(6/98,6.1%)发生TA冠状动脉受累。均为女性,年龄15 - 51岁(32±16岁)。临床表现为典型心绞痛,心电图ST段压低。其中5例心肌酶升高,符合非ST段抬高型心肌梗死诊断。4例有外周动脉受累,另2例仅有冠状动脉受累。冠状动脉造影有助于明确诊断。冠状动脉开口最常受累。5例患者通过药物洗脱支架成功实现冠状动脉血运重建,心绞痛症状改善。然而,1例患者在经皮冠状动脉介入治疗(PCI)后3个月出现支架内再狭窄。

结论

TA冠状动脉受累并不少见,尤其是冠状动脉开口。患者通常表现为非ST段抬高型心肌梗死。药物洗脱支架PCI可能改善症状,但长期效果有待进一步研究。

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