1例肥胖患者孤立性急性肾梗死

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摘要

背景:未控制的心血管(CV)危险因素与动脉粥样硬化的高发生率有关。肥胖本身可能导致严重的心脏疾病,包括导致急性事件的动脉粥样硬化。病例:46岁肥胖患者,左腹痛放射至左象限和左睾丸。实验室未见明显异常,但影像学显示左肾下极可能是由于肾梗死(图1),腹部ct血管造影(CTA)显示左肾下极前三分之二的梗死(图2)继发于供血小下节段动脉闭塞和轻微动脉粥样硬化。经胸超声心动图(TTE)显示LVOT的密度可能是伪影或钙化(图3)。经食管超声心动图(TEE)显示降主动脉III级动脉粥样硬化改变(图4),主动脉弓,胸主动脉可见可移动斑块。结论:心血管危险因素与多种血管并发症有关。肥胖作为单一心血管危险因素与晚期动脉疾病相关;我们的病例是一个不稳定的动脉粥样硬化病变导致血栓形成和肾缺血的例子,患者没有其他血栓形成的危险因素。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Isolated acute renal infarction in an obese patient
Background: Uncontrolled cardiovascular (CV) risk factors is been related to a higher incidence of atherosclerosis. Obesity itself could predispose to significant cardiac disease including arterial atheromatous leading to acute events. Case: A 46 years old obese patient who presented with left abdominal pain radiating to the left quadrant and left testicle. No significant abnormality was observed in the laboratories, but imaging showed left renal lower pole may be due to renal infarct (Figure 1), and CT-Angiography (CTA) of the abdomen showed infarction of the anterior two-thirds of the lower pole of the left kidney (Figure 2) secondary to occlusion of the supplying small inferior segmental artery and minimal atherosclerosis. Transthoracic Echocardiogram (TTE) showed a density in the LVOT may be artifact vs. calcification (Figure 3). A transesophageal echocardiogram (TEE) showed Grade III atherosclerotic changes of descending aorta (Figure 4), aortic arch, and a mobile plaque seen in the thoracic aorta. Conclusion: Cardiovascular risk factors have been associated with multiple vascular complications. Obesity as a single cardiovascular risk factor is associated with advanced arterial disease; our case is an example of an unstable atheromatous lesion causing thrombosis and ischemia in the kidney in a patient without another risk factor for thrombosis.
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