多发性大动脉炎并扩张型心肌病案例诊断分析

A Diagnosis Case Analysis of Takayasu Arteritis with Dilated Cardiomyopathy

摘要: 目的：探索多发性大动脉炎(Takayasu’s arteritis, TA)及并发症的临床特征及诊断，为大动脉炎的及时治疗提供科学依据。方法：回顾1例22岁女性，以肾功能衰竭为首发症状患者的临床资料，并进行文献复习。结果：患者左上肢无脉搏，超声心动图示扩张型心肌病，CT血管造影示左锁骨下动脉狭窄，左肾动脉严重狭窄，右肾动脉完全闭塞。考虑诊断为大动脉炎并扩张型心肌病。结论：大动脉炎早期临床表现不典型，极易误诊、漏诊。扩张型心肌病是其少见并发症，一旦并发，极易引起充血性心力衰竭或猝死，应引起临床工作者高度重视。

Abstract: Objective: To investigate the clinical characteristics and diagnosis of arteritis (TA) and its compli-cations, so as to provide scientific basis for the timely treatment of arteritis. Methods: a 22-year-old female with renal failure as the first symptom was reviewed. Results: the patient had no pulse in the left upper limb, the Echocardiogram showed dilated cardiomyopathy, CT angiography showed stenosis of the left subclavian artery, severe stenosis of the left renal artery, and complete occlusion of the right renal artery. The diagnosis of aortitis with dilated cardiomyopathy was considered. Conclusion: The early clinical manifestations of arteritis are atypical and easy to be misdiagnosed or missed. Dilated cardiomyopathy (DCM) is a rare complication, which can easily cause congestive heart failure or sudden death.