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抗磷脂综合征相关的急性肢体缺血:两例报告

Acute Limb-Threatening Ischemia Associated With Antiphospholipid Syndrome: A Report of Two Cases.

作者信息

Suzuki Kiwako, Uemura Tetsuji, Kikuchi Mamoru, Ishihara Yasuhiro, Ichioka Shigeru

机构信息

Assistant Professor, Department of Plastic and Reconstructive Surgery, Saga University School of Medicine, Saga, Japan; Assistant Professor, Department of Plastic and Reconstructive Surgery, Saitama Medical University, Saitama, Japan.

Professor, Department of Plastic and Reconstructive Surgery, Saga University School of Medicine, Saga, Japan.

出版信息

J Foot Ankle Surg. 2016 Nov-Dec;55(6):1318-1322. doi: 10.1053/j.jfas.2016.01.002. Epub 2016 Feb 19.

Abstract

Acute limb ischemia results from sudden deterioration in the arterial supply to the limb, occasionally leading to limb loss or fatality. Antiphospholipid syndrome (APS) is known to induce acute limb ischemia among the various etiologies responsible for arterial obstruction. APS is a systemic autoimmune disorder characterized by a combination of arterial and/or venous thrombosis and limb loss. It is often accompanied by a mild-to-moderate thrombocytopenia and elevated titers of antiphospholipid antibodies, including the lupus anticoagulant and the anticardiolipin antibodies. In the present report, we present 2 cases of acute limb ischemia due to APS associated with systemic lupus erythematosus. Angiography revealed arterial obstruction distal to the popliteal artery in both patients, and each patient eventually underwent below-the-knee amputation. Surgeons treating acute limb ischemia should remember APS, although this disease might not be common in daily clinical practice.

摘要

急性肢体缺血是由肢体动脉供血突然恶化引起的,偶尔会导致肢体丧失或死亡。在导致动脉阻塞的各种病因中,抗磷脂综合征(APS)已知可引发急性肢体缺血。APS是一种全身性自身免疫性疾病,其特征为动脉和/或静脉血栓形成以及肢体丧失。它常伴有轻度至中度血小板减少以及抗磷脂抗体滴度升高,包括狼疮抗凝物和抗心磷脂抗体。在本报告中,我们呈现了2例因APS合并系统性红斑狼疮导致的急性肢体缺血病例。血管造影显示两名患者腘动脉远端均存在动脉阻塞,且每位患者最终均接受了膝下截肢手术。治疗急性肢体缺血的外科医生应牢记APS,尽管这种疾病在日常临床实践中可能并不常见。

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