免疫异常的血栓闭塞性脉管炎伴多发性周围神经病变1例
One Case of Immunoabnormal Vasculitis Obliterans with Multiple Peripheral Neuropathy
DOI: 10.12677/ACM.2022.125577, PDF,   
作者: 程 敏*：西安医学院，陕西 西安；马敏江, 吕 桦, 崔小丽#：陕西省人民医院神经内一科，陕西 西安
关键词: 免疫异常；血栓闭塞性脉管炎；诊断；治疗；Immune Abnormalities； Thromboangiitis Obliterans； Diagnosis； Treatment
摘要: 血栓闭塞性脉管炎(TAO)或Buerger病是一种病因不明的节段性炎症性血栓闭塞性周围血管疾病，通常累及年轻男性吸烟者的中、小血管。目前研究认为TAO是一种与免疫和自身免疫相关的炎症性疾病，但还未有明确的生物标志物表明在有异常疾病表现的患者或有动脉粥样硬化或自身抗体的风险因素的患者中可以诊断为TAO，因此对于TAO的诊断和治疗仍然存在巨大的争议。因此本研究通过对1例免疫异常的TAO患者诊疗过程做一汇报，同时对目前TAO最新研究进展进行简要综述，提出对TAO的诊断及治疗的体会。
Abstract: Thromboangiitis obliterans (TAO) or Buerger’s disease is a segmental inflammatory thrombo- oc-clusive peripheral vascular disease of unknown etiology, usually involving the medium and small vessels in young male smokers. Current studies suggest that TAO is an inflammatory disease asso-ciated with immunity and autoimmunity, but there are no clear biomarkers that suggest a diagno-sis of TAO in patients with abnormal disease manifestations or risk factors for atherosclerosis or autoantibodies, so the diagnosis and treatment of TAO remains highly controversial. Therefore, this study presents a report on the diagnosis and treatment of TAO in a patient with immune abnormal-ities and a brief review of the latest research advances in TAO, and presents the experience on the diagnosis and treatment of TAO.
文章引用：程敏, 马敏江, 吕桦, 崔小丽. 免疫异常的血栓闭塞性脉管炎伴多发性周围神经病变1例[J]. 临床医学进展, 2022, 12(5): 3977-3984. https://doi.org/10.12677/ACM.2022.125577

参考文献

[1] Sun, X.L., Law, B.Y., de Seabra Rodrigues Dias, I.R., Mok, S.W.F., He, Y.Z. and Wong, V.K. (2017) Pathogenesis of Thromboangiitis Obliterans: Gene Polymorphism and Immunoregulation of Human Vascular Endothelial Cells. Athero-sclerosis, 265, 258-265. [Google Scholar] [CrossRef] [PubMed]
[2] Olin, J.W. (2000) Thromboan-giitis Obliterans (Buerger’s Disease). The New England Journal of Medicine, 343, 864- 869. [Google Scholar] [CrossRef] 
[3] Vijayakumar, A., Tiwari, R. and Kumar Prabhuswamy, V. (2013) Thromboangiitis Obliterans (Buerger’s Disease)- Current Practices. International Journal of Inflammation, 2013, Article ID: 156905. [Google Scholar] [CrossRef] [PubMed]
[4] Joviliano, E.E., Dellalibera-Joviliano, R., Dalio, M., Evora, P.R. and Pic-cinato, C.E. (2009) Etiopathogenesis, Clinical Diagnosis and Treatment of Thromboangiitis Obliterans—Current Practic-es. International Journal of Angiology, 18, 119-125. [Google Scholar] [CrossRef] [PubMed]
[5] Jorge, V.C., Araújo, A.C., Noronha, C., Panarra, A., Riso, N. and Vaz Riscado, M. (2011) Buerger’s Disease (Thromboangiitis Obliterans): A Diagnostic Challenge. BMJ Case Reports, 2011, bcr0820114621. [Google Scholar] [CrossRef] [PubMed]
[6] Shionoya, S. (1998) Diagnostic Criteria of Buerger’s Disease. In-ternational Journal of Cardiology, 66, S243-S245. [Google Scholar] [CrossRef] 
[7] 吕开平, 郭发才. 血栓闭塞性脉管炎的免疫相关性研究进展[J]. 血管与腔内血管外科杂志, 2018, 4(6): 556-560.
[8] 秦传子, 马军. NLRP3炎性小体在血栓闭塞性脉管炎发病机制中的作用研究进展[J]. 疑难病杂志, 2017, 16(4): 415-418.
[9] Fazeli, B. and Ravari, H. (2014) A Dis-ease-Specific Activity Score for Thromboangiitis Obliterans. Vascular, 22, 336-340. [Google Scholar] [CrossRef] [PubMed]
[10] Akbarin, M.M., Ravari, H., Rajabnejad, A., Valizadeh, N. and Fazeli, B. (2016) Investigation of the Etiology of Anemia in Thromboangiitis Obliterans. International Journal of Angi-ology, 25, 153-158. [Google Scholar] [CrossRef] [PubMed]
[11] Sena, C.M., Leandro, A., Azul, L., Seiça, R. and Perry, G. (2018) Vascular Oxidative Stress: Impact and Therapeutic Approaches. Frontiers in Physiology, 9, Article No. 1668. [Google Scholar] [CrossRef] [PubMed]
[12] Marchio, P., Guerra-Ojeda, S., Vila, J.M., Aldasoro, M., Victor, V.M. and Mauricio, M.D. (2019) Targeting Early Atherosclerosis: A Focus on Oxidative Stress and Inflammation. Oxi-dative Medicine and Cellular Longevity, 2019, Article ID: 8563845. [Google Scholar] [CrossRef] [PubMed]
[13] Senoner, T. and Dichtl, W. (2019) Oxidative Stress in Cardiovascular Diseases: Still a Therapeutic Target? Nutrients, 11, 2090. [Google Scholar] [CrossRef] [PubMed]
[14] Ito, F., Sono, Y. and Ito, T. (2019) Measurement and Clinical Significance of Lipid Peroxidation as a Biomarker of Oxidative Stress: Oxi-dative Stress in Diabetes, Atherosclerosis, and Chronic Inflammation. Antioxidants (Basel), 8, 72. [Google Scholar] [CrossRef] [PubMed]
[15] Alamdari, D.H., Ravarit, H., Tavallaie, S. and Fazeli, B. (2014) Oxida-tive and Antioxidative Pathways Might Contribute to Thromboangiitis Obliterans Pathophysiology. Vascular, 22, 46-50. [Google Scholar] [CrossRef] [PubMed]
[16] 伍慧丽, 时红波, 刘燕敏, 等. 性别差异对自身免疫性肝炎患者临床特征及预后的影响[J]. 临床肝胆病杂志, 2021, 37(7): 1636-1643.
[17] Omoyinmi, E., Mohamoud, I., Gil-mour, K., Brogan, P.A. and Eleftheriou, D. (2018) Cutaneous Vasculitis and Digital Ischaemia Caused by Heterozygous Gain-of-Function Mutation in C3. Frontiers in Immunology, 9, Article No. 2524. [Google Scholar] [CrossRef] [PubMed]
[18] Augusto, J.F., Langs, V., Demiselle, J., Lavigne, C., Brilland, B., Duveau, A., Poli, C., Chevailler, A., Croue, A., Tollis, F., Sayegh, J. and Subra, J.F. (2016) Low Serum Complement C3 Levels at Diagnosis of Renal ANCA-Associated Vasculitis Is Associated with Poor Prognosis. PLoS ONE, 11, e0158871. [Google Scholar] [CrossRef] [PubMed]
[19] Fehérvári, M., Krepuska, M., Széplaki, G., Apor, A., Sótonyi, P., Prohászka, Z., Acsády, G. and Szeberin, Z. (2014) The Level of Complement C3 Is Associated with the Se-verity of Atherosclerosis But Not with Arterial Calcification in Peripheral Artery Disease. International Angiology, 33, 35-41.
[20] Halacheva, K.S., Manolova, I.M., Petkov, D.P. and Andreev, A.P. (1998) Study of Anti-Neutrophil Cyto-plasmic Antibodies in Patients with Thromboangiitis Obliterans (Buerger’s Disease). Scandinavian Journal of Immunol-ogy, 48, 544-550.
[21] Guo, Y., Dai, Y., Lai, J. and Fan, Y. (2013) Study about Correlation of Anti-Neutrophil Cyto-plasmic Antibodies and Anticardiolipin Antibodies with Thromboangiitis Obliterans. Vascular, 21, 363-368. [Google Scholar] [CrossRef] [PubMed]
[22] Shanmugam, V.K., Angra, D., Rahimi, H. and McNish, S. (2017) Vasculitic and Autoimmune Wounds. Journal of Vascular Surgery: Venous and Lymphatic Disorders, 5, 280-292. [Google Scholar] [CrossRef] [PubMed]
[23] Chavoshan, A., Sharebiani, H., Taheri, H. and Fazeli, B. (2019) Antiphospholipid Antibodies in Buerger’s Disease. Thrombosis Research, 181, 64-66. [Google Scholar] [CrossRef] [PubMed]
[24] Undas, A., Nowakowski, T., Cieśla-Dul, M. and Sadowski, J. (2011) Abnormal Plasma Fibrin Clot Characteristics Are Associated with Worse Clinical Outcome in Patients with Pe-ripheral Arterial Disease and Thromboangiitis Obliterans. Atherosclerosis, 215, 481-486. [Google Scholar] [CrossRef] [PubMed]
[25] Raymackers, J.M. and Bosschaert, P. (2014) Cerebral Venous Thrombosis and Buerger’s Disease. Acta Neurologica Belgica, 114, 139-140. [Google Scholar] [CrossRef] [PubMed]
[26] Avcu, F., Akar, E., Demirkiliç, U., Yilmaz, E., Akar, N. and Yalçin, A. (2000) The Role of Prothrombotic Mutations in Patients with Buerger’s Disease. Thrombosis Research, 100, 143-147. [Google Scholar] [CrossRef] 
[27] Beigi, A.A., Hoghoughi, M.A., Eshaghian, A., Zade, A.H. and Masoudpour, H. (2014) The Role of Folic Acid on the Hyperhomocysteinemia in the Buerger’s Disease (Thromboangiitis Obliterans). Journal of Research in Medical Sciences, 19, 1034-1037.

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