本文選題：巨細(xì)胞動(dòng)脈炎 + 視力喪失�。� 參考：《卒中與神經(jīng)疾病》2016年05期

【摘要】：目的探討合并多種并發(fā)癥的巨細(xì)胞動(dòng)脈炎(Giant cell arteritis,GCA)患者臨床特點(diǎn)。方法根據(jù)美國(guó)風(fēng)濕病學(xué)學(xué)會(huì)(ACR)分類標(biāo)準(zhǔn)診斷一例合并左眼視力喪失及后循環(huán)梗死的巨細(xì)胞動(dòng)脈炎患者,并復(fù)習(xí)相關(guān)國(guó)外文獻(xiàn)進(jìn)行分析。結(jié)果 86歲女性患者,雙側(cè)顳動(dòng)脈增粗變硬,ESR108mm/h,顱腦MRI檢查可見(jiàn)雙側(cè)小腦半球、腦干及右側(cè)枕葉多發(fā)急性梗死灶,右側(cè)椎動(dòng)脈超聲檢查可見(jiàn)血管壁內(nèi)膜均勻一致增厚,管腔向心性狹窄。最終診斷:(1)巨細(xì)胞動(dòng)脈炎;(2)腦梗死;(3)左眼失明。結(jié)論 GCA最常累及顳動(dòng)脈,其次是椎動(dòng)脈、眼動(dòng)脈及后睫狀動(dòng)脈,可引起視力喪失及后循環(huán)梗死等嚴(yán)重并發(fā)癥。超聲檢查是明確診斷及評(píng)估治療效果的有效手段。
[Abstract]:Objective to investigate the clinical features of Giant cell arteritis (GCA) patients with multiple complications. Methods A case of giant cell arteritis with left eye vision loss and posterior circulation infarction was diagnosed according to the ACR classification criteria of the American Society of Rheumatology. Results in 86-year-old female patients, bilateral temporal artery thickening and hardening (ESR 108mm / h), craniocerebral MRI examination showed multiple acute infarct foci in bilateral cerebellar hemisphere, brain stem and right occipital lobe. Concentric stenosis of the lumen. Final diagnosis: 1) giant cell arteritis 2) cerebral infarction 3) left eye blindness. Conclusion the temporal artery, vertebral artery, ophthalmic artery and posterior ciliary artery are the most frequently involved in GCA, which can cause serious complications such as visual loss and posterior circulation infarction. Ultrasonic examination is an effective method to diagnose and evaluate the therapeutic effect.
【作者單位】： 武漢大學(xué)人民醫(yī)院神經(jīng)內(nèi)科;
【基金】：湖北省衛(wèi)計(jì)委重點(diǎn)項(xiàng)目(WJ2015MA007) 武漢市科技局2015年應(yīng)用基礎(chǔ)研究計(jì)劃項(xiàng)目(2015060101010047) 國(guó)家自然科學(xué)基金資助項(xiàng)目(項(xiàng)目批準(zhǔn)號(hào)為81301010)
【分類號(hào)】：R743

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