多发性大动脉炎57例临床分析

目的 分析多发性大动脉炎(TA)患者血管受累的特点,探讨该疾病累及血管全程者与仅累及血管起始端者临床表现的差异.方法 回顾性总结57例诊断明确并接受过全身CT血管成像(CTA)检查的TA患者的临床资料,按受累血管病变部位的不同,将其分为病变血管全程受累的患者组(以下简称全程组)和病变血管仅起始端受累的患者组(以下简称起始端组),比较两组间差异.结果 (1)TA患者男女比1∶10.4,临床分型以广泛型最为常见,最常累及颈总动脉及锁骨下动脉.(2)全程组与起始端组患者比例为1.28∶1;全程组从发病到确诊时间长于起始端组,临床分型中头臂动脉型少于起始端组(P＜0.05).(3)全程组患者以头痛等非特异症状起病较多;且病程中出现间歇运动障碍、体重下降和小便异常等症状的概率要高于起始端组(P＜0.05).(4)全程组中37.5%的患者C反应蛋白(CRP)升高,而起始端组高达64%(P＜0.05).结论 TA累及血管全程者并非少见,其起病更为隐匿、CRP阳性率低,应注意早期诊断.

Abstract：

Objective To analyze the characteristics of vascular involvement in Takayasu's arteritis (TA) patients and explore the differences between the involvements of whole range versus origin of vessels and those whose origin of vessecs were involved. Methods A total of 57 TA patients were divided into the origin and whole range groups according to their CTA (computed tomography angiography) examination reports. Then a retrospective analysis was performed on their clinical data. Results (1) TA had a female arteries were the most common sites of involvement. (2) The ratio of whole range and origin groups was group was 1.28∶1.The delay of whole range group from the onset to a correct diagnosis was longer than that of origin group (P ＜ 0. 05 ). The rate of aortic arch type in whole range group was less than that in origin group (P ＜0. 05 ). (3) More patients in whole range group had the initial symptom of headache than those in origin group, as well as the subsequent symptoms of claudication, weight loss and urination problems (P ＜0. 05 ).(4)37.5% of patients in whole range group and 64% in origin group had an elevated level of C-reactive protein (CRP) (P ＜ 0. 05 ). Conclusion Patients with whole range of arteries involved in TA are common. With atypical clinical manifestations and a low positive rate of CRP, a diagnostic delay is an important issue. Thus due attention should be paid to its clinical diagnosis and treatment.

Clinical analysis of 57 patients with Takayasu's arteritis

Objective To analyze the characteristics of vascular involvement in Takayasu's arteritis (TA) patients and explore the differences between the involvements of whole range versus origin of vessels and those whose origin of vessecs were involved. Methods A total of 57 TA patients were divided into the origin and whole range groups according to their CTA (computed tomography angiography) examination reports. Then a retrospective analysis was performed on their clinical data. Results (1) TA had a female arteries were the most common sites of involvement. (2) The ratio of whole range and origin groups was group was 1.28∶1.The delay of whole range group from the onset to a correct diagnosis was longer than that of origin group (P ＜ 0. 05 ). The rate of aortic arch type in whole range group was less than that in origin group (P ＜0. 05 ). (3) More patients in whole range group had the initial symptom of headache than those in origin group, as well as the subsequent symptoms of claudication, weight loss and urination problems (P ＜0. 05 ).(4)37.5% of patients in whole range group and 64% in origin group had an elevated level of C-reactive protein (CRP) (P ＜ 0. 05 ). Conclusion Patients with whole range of arteries involved in TA are common. With atypical clinical manifestations and a low positive rate of CRP, a diagnostic delay is an important issue. Thus due attention should be paid to its clinical diagnosis and treatment.