behÇet病伴冠状动脉累及1例报告

A. Şahin, N. Çabuk Çelik, I. Yalcin, B. Karakaş, B. Karataş
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摘要

我们报告一例因behaperet病引起的冠状动脉血栓形成。患者49岁,女性,诊断为behaperet病,经我们随访,因突发性压力型胸痛申请急诊科,心电图示心肌酶升高,前导联ST段抬高,诊断为急性心肌梗死。冠状动脉造影显示左前降支(LAD)和旋支(CX)管腔近全血栓形成,给予抗凝治疗。发现患者的心脏风险较低,并根据心肌梗死作出鉴别诊断。因此,我们在咨询的患者中调查了高凝性的原因,发现急性期反应物高。这与behet病的冠状动脉受累有关,除了抗聚集剂、他汀类药物、血管紧张素受体阻滞剂、静脉注射(IV)大剂量甲基强的松龙和环磷酰胺-mesna治疗外,还给予免疫抑制目的。不应忘记,behaperet病可能累及血管,冠状动脉也可能受到影响。
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A CASE REPORT OF BEHÇET'S DISEASE WITH CORONARY ARTERY INVOLVEMENT
ABSTRACT We present a case of coronary artery thrombosis due to Behçet's disease. A 49-year-old female patient, diagnosed with Behçet's disease and followed up by us, applied to the emergency department with sudden onset of pressure-type chest pain, and was evaluated as acute myocardial infarction due to elevated cardiac enzymes and ST segment elevation in the anterior leads on electrocardiography (ECG). Coronary angiography revealed near-total thrombosis in the lumen of the left anterior descending artery (LAD) and in the circumflex (CX) artery,it was intervened with anticoagulant therapy. The patient's cardiac risk was found to be low and differential diagnosis was made in terms of myocardial infarction. Thereupon, the causes of hypercoagulability were investigated in the patient who was consulted to us, and acute phase reactants were found to be high. This was related to the coronary artery involvement of Behçet's disease and in addition to the treatment containing antiaggregant, statin, angiotensin receptor blocker, intravenous (IV) high-dose methylprednisolone and cyclophosphamide-mesna treatment was given for immunosuppressive purposes. It should not be forgotten that there may be vascular involvement due to Behçet's disease and coronary arteries may also be affected.
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