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常染色体显性多囊肾病患者的冠状动脉瘤

Coronary aneurysms in patients with autosomal dominant polycystic kidney disease.

作者信息

Hadimeri H, Lamm C, Nyberg G

机构信息

Department of Internal Medicine, Höglandssjukhuset, Eksjö, Sweden.

出版信息

J Am Soc Nephrol. 1998 May;9(5):837-41. doi: 10.1681/ASN.V95837.

Abstract

Patients with autosomal dominant polycystic kidney disease (ADPKD) have an increased risk of intracranial aneurysms. Reports on arterial aneurysms in other locations have not been conclusive. The present study was initiated to investigate the prevalence of coronary aneurysms. Thirty ADPKD patients who had undergone coronary angiography on clinical indication were identified, 15 after renal transplantation. For each ADPKD patient, a control patient was identified with end-stage renal disease, investigated by coronary angiography, and matched for age, sex, and time relation to transplantation. All angiograms were retrieved and reevaluated with respect to aneurysms, defined as an increase in artery diameter by 50% or more, as well as to pathologic ectasias not fulfilling this criterion. Aneurysms were detected in four ADPKD patients and two control subjects. Five more ADPKD patients, but none of the control subjects, had minor ectasias. One ADPKD patient had a dissecting aortic aneurysm, and another died of aortic dissection during bypass surgery. This study adds to the evidence of an increased risk of extracranial aneurysms in ADPKD patients.

摘要

常染色体显性遗传性多囊肾病(ADPKD)患者颅内动脉瘤风险增加。关于其他部位动脉动脉瘤的报告尚无定论。本研究旨在调查冠状动脉瘤的患病率。确定了30例因临床指征接受冠状动脉造影的ADPKD患者,其中15例在肾移植后。为每位ADPKD患者确定一名患有终末期肾病的对照患者,通过冠状动脉造影进行研究,并在年龄、性别和移植时间关系方面进行匹配。检索所有血管造影照片,并重新评估是否存在动脉瘤(定义为动脉直径增加50%或更多)以及不符合该标准的病理性扩张。在4例ADPKD患者和2例对照受试者中检测到动脉瘤。另有5例ADPKD患者有轻微扩张,但对照受试者中未发现。1例ADPKD患者患有主动脉夹层动脉瘤,另1例在搭桥手术期间死于主动脉夹层。本研究进一步证明了ADPKD患者颅外动脉瘤风险增加。

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