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主动脉受累于播散性结核病——诊断之外的挑战

Aortic Involvement in Disseminated Tuberculosis - Challenges Beyond the Diagnosis.

作者信息

Shi Yunzhen, Guo Wanru, Hu Wenjuan, Li Xiaomeng, Shangguan Yanwan, Feng Xuewen, Hu Ming, Xia Jiafeng, Wang Shuting, Li Jingnan, Hong Li, Lu Bin, Xu Kaijin

机构信息

Department of Infectious Diseases, Dongyang People's Hospital, Dongyang, People's Republic of China.

State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, People's Republic of China.

出版信息

Infect Drug Resist. 2022 May 23;15:2633-2638. doi: 10.2147/IDR.S361168. eCollection 2022.

Abstract

Tuberculous aortitis (TA) is a rare disease with a high mortality rate. Aortic pseudoaneurysm is the most common vascular pattern of TA, and isolated arterial wall thickening and arterial stenosis can also be seen in TA. We report two cases of disseminated tuberculosis involving the aorta with clinical improvement after treatment. One patient who had an aortic ulcer and intermural hematoma received anti-tuberculosis along with steroids therapy. The other patient, who developed a tubercular abdominal aortic pseudoaneurysm during anti-tuberculosis therapy, successfully received endovascular stent implantation. Clinicians should be aware that TA should be considered in patients with aortitis and active tuberculosis.

摘要

结核性主动脉炎(TA)是一种罕见但死亡率很高的疾病。主动脉假性动脉瘤是TA最常见的血管表现形式,TA也可见孤立性动脉壁增厚和动脉狭窄。我们报告两例累及主动脉的播散性结核病患者,经治疗后临床症状改善。一例患有主动脉溃疡和壁内血肿的患者接受了抗结核治疗并联合使用了类固醇。另一例患者在抗结核治疗期间发生了结核性腹主动脉假性动脉瘤,成功接受了血管内支架植入术。临床医生应意识到,对于患有主动脉炎和活动性结核病的患者,应考虑到TA的可能。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f082/9139337/5fed0e333e7f/IDR-15-2633-g0001.jpg

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