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患者男,42岁。血压升高15年,双下肢间歇性跛行1年。15年前无明显诱因出现头痛,血压升高达260/180mm Hg,服降压药物效果不明显,未进一步治疗。近年来出现双下肢发凉、麻木,活动后酸痛,来我院就诊,行双下肢动脉血管超声检查。双侧下肢动脉管腔结构清晰,内膜光滑,彩色血流信号充盈尚可。频谱多普勒显示血流呈低速、低阻,典型“小慢波”改变(图1),提示近端存在狭窄。由于双侧下肢出现同样表现,考虑狭窄位于腹主动脉水平。
Male patient, 42 years old. 15 years of elevated blood pressure, intermittent claudication of lower limbs for 1 year. 15 years ago, there was no obvious incentive to headache, blood pressure up to 260 / 180mm Hg, antihypertensive drug effect is not obvious, no further treatment. In recent years, both lower extremities cold, numbness, soreness after activities, to our hospital, line double lower extremity arterial ultrasound. Both lower extremity arterial lumen structure is clear, the lining is smooth, the color flow signal filling is acceptable. Spectrum Doppler showed that blood flow was slow, low resistance, typical “small slow wave” changes (Figure 1), suggesting the presence of proximal stenosis. Due to the same appearance of both lower extremities, consider stenosis at the level of the abdominal aorta.