多发性大动脉炎临床特征与疗效分析

Clinical features and curative effect of Takayasu arteritis

目的探讨多发性大动脉炎(Takayasu arteritis,TA)患者的临床、血管影像特征,分析治疗及转归。方法回顾性分析我院心内科收治的73例TA患者的临床资料。结果 TA临床表现多样。血管造影示以Ⅰ、Ⅳ和Ⅴ为主,而Ⅱa、Ⅱb、Ⅲ少见;炎症活动评估以血沉(erythrocyte sedimentation rate,ESR)、C反应蛋白(C-reactive protein,CRP)升高。24例接受糖皮质激素和免疫抑制剂,14例单用激素;不同药物治疗患者在年龄、ESR、CRP之间有统计学差异(P<0.05),在支架置入、置入术后再狭窄及未支架置入之间无统计学差异(P>0.05)。结论 TA患者早期缺乏特异性临床表现,但ESR和CRP有助于指导治疗方案的制定及疗效评估。

Objective To study the clinical and angiographic features, treatment and prognosis of patients with Takayasu arteritis（TA）. Methods Clinical data about 73 TA patients admitted to our hospital were retrospectively analyzed. Results TA was characterized by various clinical manifestations. Angiography showed that types I, IV, and V were commonly found while types II a, 1I b, and HI were seldom seen. Its erythrocyte sedimentation rate（ESR） and C-reactive protein（CRP） level were high. Twenty-four TA patients were treated with glucocorticoids and immunosuppressive agents and 14 with only glucocorticoids. A significant difference was observed in age, ESR and CRP（P〈0.05） while no significant difference was found in those of patients after stent implantation, no stent implantation and restenosis after stent implantation（P〉0.05）. Conclusion Early TA patients are lack of specific clinical manifestations and diagnostic markers, but ESR and CRP contribute to the formulation of its treatment plan and curative effect evaluation.