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[儿童结节性多动脉炎导致心肌梗死——病例报告]

[MYOCARDIAL INFARCTION AS A CONSEQUENCE OF CHILDHOOD POLYARTERITIS NODOSA – CASE REPORT].

作者信息

Buljević Biktorija Ana, Trbušić Matias, Delić-Brkljačić Diana, Malčić Ivan

出版信息

Reumatizam. 2016;63(2):15-20.

Abstract

Polyarteritis nodosa (PAN) is a systemic vasculitis histologically characterized by necrotic lesions of small and medium- sized arteries occurring mostly in their bifurcations. PAN is a multi-organ disorder that affects numerous visceral arteries and leads to inflammation and necrosis, which may result in ischemia of vital organs. The etiology of the disease is unknown. It occurs in four forms - cutaneous (most common), classic, systemic, and microscopic. PAN preferably affects the renal and coronary arteries. The most common findings in the affected blood vessels are aneurysm, thrombosis, and stenosis. Cardiac complications are rare in children, but 35% of patients develop a complication in adulthood. The most common complication in adulthood is cardiac decompensation, which can be explained as a consequence of longstanding hypertension and changes in coronary blood vessels. The incidence of myocardial infarction is low, particularly in young patients. This paper describes a 25-year-old patient with acute myocardial infarction accompanied by changes in the coronary blood vessels and persistent arterial hypertension as a result of PAN diagnosed in childhood.

摘要

结节性多动脉炎(PAN)是一种系统性血管炎,组织学特征为中小动脉的坏死性病变,主要发生在动脉分支处。PAN是一种多器官疾病,会影响众多内脏动脉并导致炎症和坏死,这可能导致重要器官缺血。该病病因不明。它有四种形式——皮肤型(最常见)、经典型、全身型和显微镜下型。PAN最常累及肾动脉和冠状动脉。受累血管最常见的表现是动脉瘤、血栓形成和狭窄。心脏并发症在儿童中罕见,但35%的患者在成年期会出现并发症。成年期最常见的并发症是心脏失代偿,这可以解释为长期高血压和冠状动脉血管变化的结果。心肌梗死的发生率较低,尤其是在年轻患者中。本文描述了一名25岁的患者,因儿童期诊断为PAN而出现急性心肌梗死,并伴有冠状动脉血管变化和持续性动脉高血压。

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