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儿童结核分枝杆菌感染致血管炎两例报告并文献复习OACSTPCD

Vasculitis caused by Mycobacterium tuberculosis infection in children:report of two cases and literature review

中文摘要英文摘要

目的 探讨结核分枝杆菌感染(结核感染)导致血管炎的临床特点,提高临床工作者对结核感染的认识水平.方法 回顾性分析 2 例因结核感染引起血管炎患儿的临床资料,并在中国知网和万方数据库以"血管炎""结核感染"和"儿童"为关键词,在PubMed数据库以"vasculitis""tuberculosis infection"和"child"为关键词检索和复习相关文献.结果 2 例患儿均因反复发热伴局部疼痛入院,完善血管超声提示相应部位血管壁弥漫性增厚或异常回声,查结核菌素纯蛋白衍化物(PPD)试验阳性,结核感染T细胞斑点试验(T-SPOT)阳性,胸部CT提示肺部炎症,确诊结核性血管炎,抗结核治疗后血管病变痊愈.文献报道,结核感染引起的血管炎以主动脉扩张或瘤样变为主,也可以累及视网膜、脑血管等,抗结核治疗对这类血管病变有效.结论 结核感染可引起血管炎,不同大小的动静脉均可能受累.临床上对于较长时间发热伴局部疼痛的患儿,应进行结核病的相关检查及血管超声检查,防止漏诊、误诊.

Objective To investigate the clinical characteristics of vasculitis caused by Mycobacterium tuberculosis infection(tuberculosis infection)and to deepen clinical professionals'understanding of this condition.Methods Clinical data of two children diagnosed with vasculitis caused by tuberculosis infection were retrospectively analyzed.Relevant studies were searched and reviewed from CNKI,Wanfang Database and PubMed by using the keywords of"vasculitis""tuberculosis infection"and"child".Results Two children were admitted to hospital due to recurrent fever complicated with local pain.Vascular ultrasound indicated diffuse thickening or abnormal echoes on the walls of the corresponding vessels.The purified protein derivative(PPD)test and the tuberculosis infection T-cell spot test(T-SPOT)yielded positive results.Chest CT scan suggested pulmonary inflammation,and the diagnosis of tuberculosis infection complicated with vasculitis was confirmed.After anti-tuberculosis treatment,the vascular lesions were cured.According to literature review,vasculitis caused by tuberculosis infection is mainly manifested as aortic dilation or aneurysm,and can also involve the retina and cerebral vessels,etc.Anti-tuberculosis treatment is effective for such vascular lesions.Conclusions Tuberculosis infection can cause vascular lesions,and affect the arteries and veins of different sizes.In clinical practice,for patients with prolonged fever accompanied by local pain,tuberculosis related examination and vascular ultrasound examinations should be conducted to prevent missed diagnosis and misdiagnoses.

蔡王精;檀卫平;邱坤银;张碧红

中山大学孙逸仙纪念医院儿科,广东 广州 510120

结核分枝杆菌感染血管炎抗结核治疗儿童血管超声

Mycobacterium tuberculosis infectionVasculitisAnti-tuberculosis treatmentChildrenVascular ultrasonography

《新医学》 2024 (008)

617-623 / 7

广东省医学科研基金项目(A2024057)

10.3969/j.issn.0253-9802.2024.08.005

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