大动脉炎与继发性高血压

Takayasu arteritis and Secondary Hypertension

大动脉炎(Takayasu arteritis,TA)是一种累及主动脉及其主要分支的慢性进行性非特异血管炎性疾病,多发于年轻女性。高血压是大动脉炎的常见临床表现之一,对于大动脉炎引起的继发性高血压,应给予积极的综合治疗,降压治疗的同时,活动期患者应用糖皮质激素和/或免疫抑制剂控制病情,酌情给予抗栓、抗动脉硬化等综合性治疗措施,对于稳定期患者必要时行介入或外科手术治疗以解除导致血压升高的血管病变或主动脉瓣病变。临床医师应提高对该疾病的认识以免造成误诊或漏诊。

Takayasu arteritis （TA） is a kind of chronic vasculitis that mainly affects the aorta and its major branches, aswell as pulmonary arteries. Women at reproductive age are most often affected. Hypertension is the common clinical manifestation of TA, which is uraually refractory to antihypertensive treatment. The management of hypertension caused by TA needs an integrated approach. Corticosteroids with/without immunosuppressive agents are the mainstay of treatment to suppress vascular inflammation, and to prevent damage to vessels, while often being accompanied by antithrombotic and anti--atherosclerosis measures. Angioplasty or surgery may be necessary in some TA patients who have symptomatic and hemodynamically significant arterial stenosis or aortic regurgitation. Improved understanding for TA in clinician will provide better diagnosis and therapy for the disease.