10例急慢性大动脉炎患者的临床特点及随诊分析

Analysis of clinical features and prognosis in 10 patients with acute and chronic takayasu’s arteritis

目的分析急慢性大动脉炎患者的临床特点,提高对大动脉炎认识。方法回顾分析我院2009~2016年收治的10例大动脉炎患者随诊的相关资料,包括性别、年龄、临床表现、实验室检查、影像学检查及治疗方案等信息。结果10例大动脉炎患者,女性7例,男性3例,中位起病年龄41岁,出现临床症状到确诊的平均病程(4.61±3.78)年。平均随诊时间2.4年,10例患者中有7例以高血压起病。6例发病初,血管病变的同时炎症指标(特别红细胞沉降率(erythrocyte sedimentation rate,ESR))明显增高,均采取积极的激素及免疫抑制剂治疗,随诊病情稳定;4例患者,确诊时ESR及C-反应蛋白(C-reactiveprotein,CRP)正常,未予积极的激素及免疫抑制剂治疗,随诊中发现3例患者受累的血管病变范围扩大,其中1例因心血管并发症死亡。结论高血压是大动脉炎患者就诊的首要原因;ESR/CRP可作为判断大动脉炎活动的标准之一,但不排除ESR/CRP均正常而血管炎症仍进展的情况;长期密切随诊对大动脉炎非常必要。

Objective To study the clinical features of Takayasu’s arteritis and improve the understanding and diagnosis of this disease.Methods We retrospectively analyzed 10 patients with Takayasu’s arteritis admitted in our hospital from 2009 to 2016 for their gender,age,clinical manifestations,laboratory examination,imaging examination and prognosis.Results Ten patients with takayasu’s arteritis were selected,including 7 females and 3 males.The median age of onset was 41 years,and the mean course of onset from clinical symptoms to diagnosis was 4.61±3.78 years.Hypertension was found in 7 out of 10 patients.At the early onset of the disease,the inflammatory biomarkers especially erythrocyte sedimentation rate(ESR)significantly increased in 6 patients with vascular lesions who were treated with glucocorticoid and immunotherapy.The condition of these patients remained stable during the 3-year followup.Four patients with normal ESR and C-reactive protein(CRP)at early onset were not treated with glucocorticoid and immunotherapy.After 3 years of follow-up,the vascular lesions of them were enlarged,and one of the patient died due to cardiovascular complications.Conclusion Hypertension is the initial symptom of takayasu’s arteritis.The levels of ESR/CRP can be used as one of the criteria to judge the development of takayasu’s arteritis in most of the cases.Thus,long-term follow-up is necessary for takayasu’s arteritis.