不同性别多发性大动脉炎患者临床特征比较

Clinical characteristics of patients with Takayasu's arteritis in different gender

目的比较男女多发性大动脉炎(TA)患者各自的临床特点,提高对男性TA患者的诊断水平。方法对2010年1月至2011年12月北京安贞医院收治的53例大动脉炎患者的临床资料进行回顾性分析。结果 (1)男女患者起病年龄比较差异无统计学意义(P>0.05)。(2)男女患者首发症状为头晕(52.8%)、胸痛/胸闷(35.8%)和间歇性跛行(32.1%);男性患者比女性患者胸痛/胸闷更为常见(63.6%vs 28.6%,P<0.05)。(3)男女患者最常见的体征是无脉症或桡动脉搏动减弱(71.0%)、血压升高(60.4%)、双上肢动脉压差>10 mmHg(40.7%,1 mmHg=0.133 kPa)。(4)实验室检查显示,男性患者较女性患者易出现肾功能损伤(72.7%vs 33.3%,P<0.05)。(5)临床分型:Ⅴ型最为多见(43.4%),其次是Ⅰ型(22.6%)和Ⅱa型(13.2%),男女患者临床分型比较差异无统计学意义(P>0.05);但男性患者更易出现弥散性血管受累(90.9%vs 57.1%,P<0.05)。(6)男性患者与女性患者合并症发生率比较差异无统计学意义(P>0.05)。结论 TA是一种高度异质性疾病,男性较女性起病稍晚,心瓣膜和胸部主动脉(主动脉弓/升主动脉)及肾脏病变相对突出,血管受累范围大,病情相对较重。

Objective To compare the clinical features of Takayasu＇s arteritis （TA） patients in different gender and improve the diagnosis level of TA in male. Methods The data of fifty-three TA patients which were treated in Anzhen Hospi- tal from January 2010 to December 2011 were analyzed retrospectively. Results （ 1 ） The onset age was （ 35 ± 11 ） years old in male patients and was（28 ± 11 ） years old in female patients, there was no statistic difference between different gener（ P 〉 0. 05）. （2） The common primary symptoms were dizziness （52.8%）, chest pain/suppression （35.8%）, and intermittent lameness（ 32.1% ） and chest pain/suppression was easily found in male patients than in female patients（63.6% vs 28.6% , P 〈0.05）. （3） The common signs were pulseless/reduced radial artery pulse（71.0% ）, elevated blood pressure（60.4% ） and blood pressure difference 〉 10 mmHg（40.7% , 1 mmHg = 0. 133 kPa）. （4）Male patients had more frequencies with ab- normal renal indexes（72.7% vs 33.3% , P = 0. 018 ）. （5） Based on image classification, the common subsets were type V （43.4%） ,type I （22.6%） and type II a（ 13.2% ）,there was no statistic difference of clinical typing between male and female（P〉 0.05 ）. Moreover, diffuse arteries lesions were more in male patients than in female individuals （90.9% vs 57.1% , P 〉 0. 05 ）. （ 6 ） There was no significant difference of complication between the male patients and female patients （ P 〉 0.05 ）. Conclusion Male patients with TA have late onset age, more aortic valve and aortic arch/ascending aorta lesions, more arteries involvements, some of which bear abnormal renal functions than female TA patients.