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目的探讨合并多种并发症的巨细胞动脉炎(Giant cell arteritis,GCA)患者临床特点。方法根据美国风湿病学学会(ACR)分类标准诊断一例合并左眼视力丧失及后循环梗死的巨细胞动脉炎患者,并复习相关国外文献进行分析。结果 86岁女性患者,双侧颞动脉增粗变硬,ESR108mm/h,颅脑MRI检查可见双侧小脑半球、脑干及右侧枕叶多发急性梗死灶,右侧椎动脉超声检查可见血管壁内膜均匀一致增厚,管腔向心性狭窄。最终诊断:(1)巨细胞动脉炎;(2)脑梗死;(3)左眼失明。结论 GCA最常累及颞动脉,其次是椎动脉、眼动脉及后睫状动脉,可引起视力丧失及后循环梗死等严重并发症。超声检查是明确诊断及评估治疗效果的有效手段。
Objective To investigate the clinical features of patients with giant cell arteritis (GCA) complicated by various complications. Methods According to the American College of Rheumatology (ACR) classification, a case of giant cell arteritis with left eye loss and posterior circulation infarction was diagnosed and the related foreign literature was reviewed. Results The 86-year-old woman had thickening and hardening of the bilateral temporal arteries. ESR108mm / h and MRI of the brain showed multiple acute infarcts in the bilateral cerebellar hemispheres, the brainstem and the right occipital lobe. The right side of the vertebral artery showed vascular wall Endometrial uniform thickening, central ventricular stenosis. Final diagnosis: (1) giant cell arteritis; (2) cerebral infarction; (3) left blindness. Conclusions GCA most often involves the temporal artery, followed by the vertebral artery, the ophthalmic artery and the posterior ciliary artery, which can cause serious complications such as loss of vision and posterior circulation infarction. Ultrasonography is an effective measure to confirm the diagnosis and evaluate the therapeutic effect.