大动脉炎及其血管造影综合分析

Aorto-arteritis: A Collective Review of Angiography in 415 Cases

目的：总结国人大动脉炎血管造影和某些临床特点，提高其认识水平。材料和方法：回顾分析４１５例大动脉炎（ＤＳＡ１７例，普通血管造影２４４例）和某些临床资料。与某些亚洲国家资料对比。结果：大动脉炎病变以狭窄－阻塞型最为常见（８４．８％），扩张－动脉瘤型少见（１．９％）；大动脉炎最常受累部位为腹主动脉及其分支（５６．８％），其中肾动脉病变占２９．７％，日本，韩国，印度则分别为３４％，７６％和９２％，主动脉弓和头臂动脉病变占３２ ８％，日本，韩国，印度则分别为９９％， ８３％和 ６０％；按 Ｌｕｐｉ－Ｈｅｒｒｅａ分型以Ⅱ型多见（３８．３％）。结论：大动脉炎是亚洲地区常见的血管疾病，但有明显的地域分布和种族差异；本病诊断ＤＳＡ已取代普通血管造影。

Purpose: In order to improve the level of knowledge of this entility, the angiographic findings and some clinical manifestations in 415 cases with aorta-arteritis among Chinese were collectively reviewed. Materials and Methods: The data of angiography and some as pects of clinical manifestations in 415 cases with aorto-arteritis studied with DSA in 171 and conventional angiography in 244, and those re sults were compared with that in other Asian countries. Results: Among the lesions of aorto-arteritis in 415 cases of the present series, the steno-occlusive type was to be the commonest in 84. 4 %, and dilative type and aneurysem formation in 1. 9 %. Abdominal aorta and its ma jor branches were the most frequently involved in cases of the the present series constituting 56. 8 % (among them renal artery, 29. 7%), and the figure was 34%, 76%, 92% reported from Japan (in 96 cases), Korea (109) and India (50) respectively; aortic arch and bra chiocephalic arteries were involved in 32. 8% of the present series, and 99%,83% and 60% were reported from Japan, Korea and India respectively. According to the classification of Lupi-Herrea type Ⅱ, lesions of aorto-arteritis were observed in 38. 3%, the commonest one of the present series. Conclusions: Aorto-arteritis is a commonly seen vascular disease in China and other countries in Asia, and however, obvious difference was found in district distribution and ethnic even among population. Conventional arteriography has been progressively replaced by DSA in the diagnostic evaluation of aorto-arteritis. Based on the angiographic findings considering both location and characteris tics of the lesion a new combined classification system of aorto-arteritis is suggested.