权卓 苏柯

[摘要] 随着人口老龄化的到来，腹主动脉瘤的发病率不断升高，其病因复杂多样，发病机制尚不明确，且其临床表现不易发现或难以确诊，致使许多患者因瘤体破裂而死亡，也使得腹主动脉瘤逐渐成为目前死亡率较高的“隐形杀手”。密切关注腹主动脉瘤与其他动脉粥样硬化性疾病之间的关系，有助于在高危人群中尽早地检查并明确诊断，从而为患者提供宝贵的治疗时机。

[关键词] 腹主动脉瘤；外周血管病；冠心病；动脉粥样硬化

[中图分类号] R654.3 [文献标识码] A [文章编号] 1674-4721（2016）03（c）-0164-03

[Abstract] With the aging of the population，the morbidity of abdominal aortic aneurysm is rising.The etiology is complicated and the pathogenesis is not clear so far， however its clinical symptoms are not easy to find or difficult to diagnosis which resulting in many patients died due to tumor rupture.The abdominal aortic aneurysm gradually become an invisible killer. It′s very crucial to pay more attention to the relationship between the abdominal aortic aneurysm and other atherosclerotic diseases，which can help to identify the high-risk populations and diagnose the patients as soon as possible.So that the patients can have precious opportunities and enough time to receive treatment.

[Key words] Abdominal aortic aneurysm；Peripheral vascular diseases；Coronary disease；Atherosclerosis

腹主动脉瘤发病率随着年龄增加而显著增加，是老年人较常见的血管疾病，死亡率较高[1]。腹主动脉瘤的临床症状多样，但多数病例早期都无明显症状，以至于延误诊治，最终导致严重结果，甚至死亡。本文从1例并发外周血管病、冠心病的腹主动脉瘤破裂死亡病例入手，认真分析，并结合文献研究，总结经验与教训，旨在提高临床医生对腹主动脉瘤的认识，特别是对一些易患患者的重视，以便及早明确诊断、及时治疗。

1 临床资料

患者，男性，74岁，因“双侧足背部疼痛1个月，加重1周”，于2014年11月19日入院，患者于入院前1个月无明显诱因地出现双侧脚趾疼痛，趾末梢发紫，以左侧第四趾为著，局部略水肿、皮温下降，无发热、寒战，无咳嗽、咳痰、呼吸困难，无心慌、胸闷、气短，无恶心、呕吐、腹痛、腹泻、里急后重，无少尿、尿痛及肉眼血尿等症状。既往有高血压及冠心病病史6年，血压最高达190/110 mmHg，间断口服降血压药物，血压控制不平稳；……