摘要
目的探讨大动脉炎临床症状、受累血管分布特征及治疗转归。方法回顾性分析173例大动脉炎患者的临床症状、血管影像学、炎性指标及治疗随诊情况。采用t检验进行统计学分析。结果173例患者中女性136例，男性37例，中位发病年龄23岁。81例（46．6％）患者起病有高血压，72例（41．1％）患者无脉症／脉搏不对称，50例（28．7％）患者有发热的症状；受累血管分布情况：主动脉112例（64．7％），肺动脉17例（9．8％），无名动脉33例（19．1％），颈总动脉114例（65．9％），锁骨下动脉113例（65．3％），肾动脉63例（36．2％），椎动脉21例（12．1％），腹腔干10例（5．8％）。105例（61．0％）患者红细胞沉降率（ESR）升高。合并活动性／既往结核者45例，占26．O％，乙型肝炎病毒携带者10例，占5．8％。其中105例患者接受随诊，98例（94．2％）在治疗后病情平稳，17例在激素减量过程中病情反复。结论糖皮质激素及（或）免疫抑制剂以及血管严重狭窄或闭塞者适时联合介入与手术，可有效控制大动脉炎患者的临床症状及炎陛指标，改善患者的生存质量。
Objective To study the clinical features, arterial involvement, therapeutic strategies and outcomes of Takayasu arteritis （TA）. Methods The clinical symptoms, arterial images, inflammatory parameters and follow-up information of 173 patients with TA were retrospectively studied. Comparisons between groups were performed by t-test. Results There were 136 female and 37 male patients in this study. The mean age at onset was （26±11） years. Hypertension, pulse deficit or asymmetrical pulse, and fever were present in 46.6%, 41.1%, 28.7% of patients, respectively. The distribution of arterial involvement were 64.7% in aorta, 9.8% in pulmonary artery, 19.1% in innominate artery, 65.9% in common carotid arteries, 65.3% in the subclavian artery, 36.2% in the renal artery, 12.1% in the vertebral artery, and 5.8% in coeliac axis. Elevated erythrocyte sedimentation rate （ESR） was found in 61.0% patients. Active tuberculosis or history of tuberculosis was implicated in 45 patients （26.0%）. Ten patients （5.8%） were hepatitis B virus carriers. Among I05 followed-up patients, 98 patients （94.2%） achieved persistent remission, 17 patients relapsed when corticosteroids were tapered. Conclusion Corticosteroids combined with or steroid alone, supplemented with endovascular intervention procedures or surgical bypass procedures when necessary, can effectively control the clinical symptoms and inflammatory parameters and improve the quality of life of patients.
出处
《中华风湿病学杂志》
CAS
CSCD
北大核心
2011年第9期604-607,共4页
Chinese Journal of Rheumatology
关键词
大动脉炎
临床特征
治疗转归
Takayasu arteritis
Clinical characteristics
Therapeutic outcomes
