一例梅毒感染合并家族性高胆固醇血症的早发心肌梗死

张滨; 吴炜

doi:10.12376/j.issn.2097-0501.2023.01.011

一例梅毒感染合并家族性高胆固醇血症的早发心肌梗死

doi: 10.12376/j.issn.2097-0501.2023.01.011

张滨¹,
吴炜^{2, 3, ,}

1.
中国医学科学院北京协和医院内科，北京 100730
2.
中国医学科学院北京协和医院心内科，北京 100730
3.
中国医学科学院北京协和医院疑难重症及罕见病国家重点实验室，北京 100730

基金项目:

中央高水平医院临床科研业务费 2022-PUMCH-B-098

详细信息

通信作者:
吴炜，E-mail：camsww@163.com

中图分类号: R541.4
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- 被引次数: 0
出版历程
- 收稿日期: 2022-11-30
- 录用日期: 2022-12-26
- 网络出版日期: 2023-03-07

An Early Onset of Myocardial Infarction Patient with Syphilis and Familial Hypercholesterolemia

ZHANG Bin¹,
WU Wei^{2, 3
, ,}

1.
Department of Internal Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
2.
Department of Cardiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
3.
State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China

Funding:

National High Level Hospital Clinical Research Funding 2022-PUMCH-B-098

More Information

Corresponding author: WU Wei, E-mail: camsww@163.com

摘要

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。
- 梅毒 /
- 家族性高胆固醇血症 /
- 冠状动脉瘤样扩张 /
- 血管内超声 /
- 光学相干断层扫描
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.
- syphilis /
- familial hypercholesterolemia /
- coronary aneurysmal ectasia /
- intravascular ultrasound /
- optical coherence tomography
注释:

作者贡献：张滨负责文章撰写；吴炜负责收集病历资料，对文章进行审阅修改。

利益冲突：所有作者均声明不存在利益冲突。

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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

下载: 全尺寸图片幻灯片

图 2 2021年12月患者再入院行CAG和冠脉光学相干断层扫描(OCT)

A.造影提示RCA再狭窄；B.OCT示RCA管腔最狭窄处面积2.13 mm²，周围可见脂质纤维成分；C.于RCA植入药物洗脱支架并予球囊后扩张；D.OCT示后扩张球囊扩张后，支架贴壁良好

Figure 2. CAG and optical coherence tomography(OCT) when the patient was readmitted into hospital in 2021-12

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参考文献(10)

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