polyarteritis
Introduction
Introduction to multiple arteritis Multiple arteritis (Takayasuarteritis, TA) refers to chronic non-specific inflammation that mainly affects the wall of the aorta, which can cause stenosis or even blockage of the lumen. The disease mainly involves the aorta and its main branches, so the blood supply to the head, upper limbs, lower limbs and internal organs may be affected, and the cause of the disease is unknown. The disease can be divided into four types, type I lesions involving the aortic arch and its branches; type II involving the descending thoracic aorta and abdominal aorta, without aortic arch; type III including type I and type II; type IV pulmonary artery damage. basic knowledge Sickness ratio: 0.0012% Susceptible people: no specific people Mode of infection: non-infectious Complications: myocardial ischemia
Cause
Causes of multiple arteritis
Arterial embolization (30%):
Mainly caused by blood clots, in addition, foreign bodies such as air, fat, cancerous plugs and catheter breaks can also become emboli, such as rheumatic heart disease, coronary atherosclerotic heart disease and bacterial endocarditis, ventricular wall thrombosis Shedding; thrombus shedding on artificial heart valves.
Vascular origin (30%):
Aneurysm or vascular lumen thrombosis; atherosclerotic plaque detachment, the main pathological changes are: early arterial spasm, subsequent endothelial cell degeneration, arterial wall degeneration; secondary thrombosis in the arterial lumen; severe ischemia After 6-12 hours, the tissue can undergo necrosis, loss of muscle and nerve function.
Iatrogenic (20%):
The arterial puncture cannula is broken into foreign body, or the endometrial tear is followed by thrombosis and shedding. Among them, cardiogenic is the most common. The embolus can be flushed into the brain, visceral and limb arteries with DC, and generally stays in the artery. In the bifurcation, in the peripheral arterial embolization, the lower extremities are more common than the upper extremities, followed by the common femoral artery, common iliac artery, radial artery and abdominal bifurcation; in the degenerative limb, the radial artery, the radial artery and the subclavian artery The main pathological changes are: early arterial spasm, subsequent endothelial cell degeneration, arterial wall degeneration; secondary thrombosis in the arterial cavity; 6-12 hours after severe ischemia, tissue necrosis, muscle and nerve function loss.
Prevention
Multiple arteritis prevention
1. Learn more about the disease and talk to your doctor about the side effects that drug treatment may cause.
2. Reasonable diet: such as high blood pressure, diabetes and osteoporosis need to reduce salt and sugar intake and increase calcium intake.
3. Appropriate exercise: It is beneficial to strengthen heart and lung function, control high blood pressure and diabetes.
Complication
Multiple arteritis complication Complications, myocardial ischemia
The most common complication of this disease is ischemia of vital organs, which can lead to death.
Symptom
Multiple arteritis symptoms common symptoms shortness of air carotid pain, severe pain, irritability, black paralysis, intermittent claudication
A small number of patients with systemic symptoms may have general malaise, fatigue, fever, loss of appetite, nausea, sweating, weight loss, myalgia, arthritis, and nodular erythema at the early stage of the disease. Local symptoms and signs vary according to the affected blood vessels. Symptoms and signs of organ ischemia.
Examine
Examination of multiple arteritis
Laboratory examination
(1) Erythrocyte sedimentation rate: It is an important indicator reflecting the disease activity of this disease. When the disease is active, the erythrocyte sedimentation rate increases, and the condition stabilizes the erythrocyte sedimentation rate and returns to normal.
(2) C-reactive protein: its clinical significance is the same as erythrocyte sedimentation rate, which is one of the indicators of disease activity of the disease, but neither is a specific index.
2. Imaging examination
(1) Color Doppler ultrasonography: stenosis or occlusion of the aorta and its main branches can be explored.
Diagnosis
Diagnosis and diagnosis of multiple arteritis
diagnosis
Acute arterial embolism has significant symptoms and signs. Anyone with a history of heart disease accompanied by atrial fibrillation or the aforementioned pathogenesis may suddenly have a 5"P" special sign, and a clinical diagnosis can be made, and the site of embolization can be estimated. The following tests can be performed. Provide an objective basis for determining the diagnosis:
1 skin temperature test: can accurately indicate the position of the temperature change zone.
2 ultrasound Doppler examination: can detect the sudden disappearance of the limb trunk artery beat, can accurately diagnose the location of the embolization.
3 angiography: can understand the embolization site, whether the distal artery is unobstructed, collateral circulation, whether there is secondary thrombosis, etc., in the determination of the diagnosis, should also be responsible for the cause of arterial embolism. Such as electrocardiogram, cardiac x-ray, biochemical and enzymatic examination, etc., in order to facilitate the development of systemic treatment programs.
