老年大动脉炎患者的临床特点分析

Analysis of clinical features of takayasu＇s arteritis in the elderly

目的总结分析老年大动脉炎患者的临床特点，加强对老年大动脉炎患者的综合治疗。方法入选阜外心血管病医院就诊的60岁以上大动脉炎病例，回顾性分析其病史、临床特点。结果26例大动脉炎患者女性22例，男性4例。发病年龄均〈40岁，其中确诊年龄≤40岁者15例．41～50岁者1例，51～60岁者7例。〉60岁者3例；26例患者中9例合并冠状动脉粥样硬化性心H庄病，7例合并高血压，4例合并2型糖尿病，2例合并心律失常，1例合并亚急性感染性心内膜炎；临床表现伴高血压者21例（81％），头晕12例（46％），胸痛9例（35％），上肢无脉或脉弱者7例（27％）；临床分型为头臂动脉型8例（30％），胸腹主动脉型4例（15％），广泛型11例（58％），肺动脉型3例（12％）；患者血沉（ESR）、C反应蛋白（CRP）、抗链球菌溶血素（ASO）升高分别为10例（50％）、6例（32％）、14例（78％）；2例死亡病例均合并糖尿病，其余患者药物治疗控制病情活动性及其他疾病和危险因素。结论老年大动脉炎患者常处于疾病活动期且可能并存其他心血管疾病和危险因素，应加强对老年大动脉炎患者的综合治疗。

Objective To analyze the clinical features of takayasu＇s arteritis in elderly patients for improving their general management. Methods Twenty-six patients, aged over 60 years, with takayasu＇s arteritis were enrolled. The clinical manifestations and medical records were collected in detail and analyzed retrospectively. Results The mean age of the patients in our study was 64.0± 3.8 years, four males and twenty-two females. Of all patients, nine were accompanied by coronary heart disease, seven by primary hypertension, four by diabetes mellitus, two by arrhythmia and one by subacute infective endocarditis. The frequent clinical manifestations were hypertension （n=21,81%）, dizzy （n=12,46%）. chest pain （n=9,35%）, pulselessness or weak pulse （n=7,27%）. The clinical classification of this group showed brachiocephalic artery type （n= 8,30%）, abdominal aorta type （n =4,15%）, extensive type （n=11, 58%） and pulmonary artery type （n=3, 12%）. Ten patients had elevated ESR level, six had elevated CRP level and fourteen had elevated ASO level. Two patients with diabetes mellitus died of serious complications. Conclusions Takayasu＇s arteritis in the elderly is usually accompanied by other cardiovascular diseases and risk factors. It is important to enhance the comprehensive treatment of these patients.