42例大动脉炎临床实验检查血管造影的研究

FORTYTWO PATIENTS WITH TAKAYASU ARTERITIS:CLINICAL,LABORATORY AND ANGIOGRAPHIC STUDIES

目的：分析４２例大动脉炎，探讨早期诊治。方法：对散在９个临床科室的４２例病人分析临床表现的异质性、常规和免疫学检查结果，所有病例均做动脉造影。结果：早期临床表现无特异性，无脉和继发性高血压发生率分别占２１４％、７８６％，约７０％可听到血管杂音。一般化验及免疫学检查无意义，多普勒彩超和肾图阳性率各８０％。动脉造影示头臂动脉型８例、主肾动脉型２９例、广泛型５例，１８例行球囊导管扩张治疗，成功１４例，较早期的９例内科治疗，７例好转。结论：早期诊断仍是今后研讨的核心，抗内皮细胞抗体和血栓调节素已提出有助诊断，动脉造影可明确病变程度并行扩张治疗，应尽早选用。

Objective :To analyze 42 patients with Takayasu arteritis,discuss early diagnosis and treatmentMethods:The clinical differentiation,conventional laboratory study,immunology test and angiography of 42 patients dispersed in 9 clinic departments were analyzedResults:No any clinical characteristics in early stage were foundThere were pulseless(214%)and secondary hypertension (786%).The murmur could be heard in the area corresponding to the narrowed artery in 70%Conventional laboratory study and immunology test were no availableThe sensitivity for arterial stenosis by Doppler color Bultrasonography and radioisotopic nephrography was about 80% Angiography could show the type of brachiocephalic trunk 8 cases,renal 29 cases and widespread 5 casesEighteen cases were treated with angioplasty,14 of them were successfulNine cases in early stage were treated with medicine,7 cases of them got remissionConclusion:Early diagnosis still remains a key problem for further studyAECA and thrombomodulin are suggested as a helpful basis for early diagnosisAngiography could explicate the degree of the lesions and do angioplasty for them,and should be adopted earlier