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An Early Onset of Myocardial Infarction Patient with Syphilis and Familial Hypercholesterolemia
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摘要: 梅毒感染可以引起心血管系统受累，但冠状动脉受累是较为少见的临床表现。家族性高胆固醇血症(FH)是一种因低密度脂蛋白胆固醇(LDL-C)清除障碍导致LDL-C水平显著升高，造成早发严重动脉粥样硬化的常染色体显性遗传疾病。本文报道一例梅毒感染合并FH的青年男性患者，临床表现为急性心肌梗死、高LDL-C血症，冠脉造影及腔内影像检查可见冠状动脉多发瘤样扩张和狭窄，经反复冠状动脉药物球囊扩张后短期内再狭窄，最终植入支架治疗。Abstract: Syphilis may affect the cardiovascular system, in which coronary arteries are less commonly involved. Familial hypercholesterolemia (FH) is an autosomal dominant inherited disease with elevated low-density lipoprotein-cholesterol (LDL-C) levels due to impaired LDL-C clearance. We report a young male patient with syphilis and FH. The clinical manifestations were acute myocardial infarction and high LDL-C levels. Coronary angiography and intracoronary imaging showed multiple aneurysmal ectasia and stenosis. A drug-eluting stent was implemented when recurrent restenosis occurred after two percutaneous coronary drug-eluting balloon angioplasties.
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图 1 2021年1月患者行冠脉造影(CAG)和血管内超声(IVUS)
A.右冠状动脉(RCA)近中段弥漫瘤样扩张，中段局限性狭窄80%；B.IVUS显示冠状动脉瘤合并狭窄，冠状动脉血管壁三层结构影像消失，局部软组织影；C.RCA经药物洗脱球囊(DCB)扩张术后；D.IVUS显示4.0 mm直径DCB扩张术后局部存在管腔弹性回缩
Figure 1. Coronary angiography(CAG) and intravenous ultrasound(IVUS) of the patient in 2021-01
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