主动脉夹层 Aortic Dissection 教育頭條網

主动脉夹层 Aortic Dissection

【Aortic Dissection 主动脉夹层】

Suprapubic adj.耻骨上的

Troponin n.肌钙蛋白

Mediastinum n.纵膈

Dilatation n.扩张

Flap n.皮瓣

Beta-blocker n.β受体阻滞剂

An 81-year-old man with no documented medical history presented to the emergency department with suprapubic pain and urinary retention resulting from benign prostatic hyperplasia. He was incidentally found to have an elevated troponin I level, at 0.17 ng per milliliter (normal value less than 0.08 ). He reported no chest or back pain or shortness of breath. There was no evidence of ischemic changes on electrocardiography. Chest radiography showed widening of the mediastinum. Transthoracic echocardiography showed aneurysmal dilatation and a dissection flap in the ascending aorta(see the video at NEJM.org). Computed tomographic angiography of the thorax and abdomen revealed an ascending aortic aneurysm and a type I DeBakey aortic dissection. The dissection involved the ascending aorta, aortic arch, and descending aorta, terminating just below the origin of the renal arteries. Given the absence of associated symptoms, the dissection was thought to be chronic. The patient declined consideration of surgical intervention but agreed to treatment with a beta-blocker. One year later, the patient's condition had not worsened; he continued to be treated with a beta-blocker and to receive routine follow-up care.¹

【译文】一名81岁无疾病史记录男性，因良性前列腺增生所致耻骨上疼痛和尿潴留就诊于急诊科。偶然发现患者肌钙蛋白I水平升高，为0.17纳克/毫升（正常值小于0.08）。患者无胸痛或者背痛或呼吸急促。心电图无缺血性改变的证据。胸片显示纵膈增宽。经胸超声心动图显示升主动脉的动脉瘤样扩张和夹层瓣（在NEJM.org观看视频）。胸部和腹部计算机断层扫描血管造影显示升主动脉瘤和DeBakey I型主动脉夹层。夹层累及升主动脉、主动脉弓和降主动脉，终止部位略低于肾动脉起始处。考虑到患者无主动脉夹层相关症状，认为夹层是慢性的。患者拒绝考虑外科手术，但是同意β受体阻滞剂治疗。一年后，患者病情没有恶化，他继续β受体阻滞剂治疗，并且定期接受随访。

【医学单词记忆之道】

1. 医学单词记忆

supra-前缀在…之上

suprarenal adj.肾上的

supraventricular adj.室上性的

suprapubic adj.耻骨上的

supraclavicular adj.锁骨上的

supramaxilla n.上颚

2. 常用医学词组

aortic Dissection 主动脉夹层

urinary retention 尿潴留

benign prostatic hyperplasia