巨细胞动脉炎与风湿性多肌痛临床特征的对比分析

目的:通过比较风湿性多肌痛（PMR）和巨细胞动脉炎（GCA）的临床差异，总结GCA患者的临床特点。方法:收集皖南医学院附属弋矶山医院风湿免疫科2010年8月至2019年9月住院的12例巨细胞动脉炎患者临床资料，并选择同期住院的，与GCA组患者进行2∶1年龄、性别相匹配的PMR患者形成对照组，比较2组患者的临床表现、实验...

Comparative analysis of clinical features between giant cell arteritis and polymyalgia rheumatica

Objective To identify the differences in clinical manifestations between Chinese giant cell arteritis(GCA)patients and polymyalgia rheumatica(PMR)patients.Methods Twelve GCA patients were included during September 2010 to September 2019 in our hospital.Clinical and laboratory data were collected.Twenty-four age and sex-matched pure PMR patients were selected as control.Statistical analysis was performed using Statistical product and service solutions(SPSS)software.The categorical variables were tested by chi square test,and the continuous variables were expressed by mean and standard deviation(±s).The comparison between groups was conducted by t-test.P<0.05 was considered statistically significant.Results In these 12 GCA patients,the onset age was 55-70(67±7)years old,and male to female ratio was 1∶11.The most common initial symptom of GCA was the same as PMR(7/12,58%).Compared with PMR patients,the specific clinical manifestations of GCA patients were scalp pain(P=0.031),mandibular claudication(P=0.031)and migraine(P=0.000).The creatine kinase of GCA(60±27)U/L patients was higher than that in PMR(41±15)patients(t=1.098,P=0.029).There was no significant difference in other laboratory tests including erythrocyte sedimentation rate,C reactive protein level.Seven of 12 GCA patients were first diagnosed with PMR,then were diagnosed with GCA during follow-up.No obvious differences could be found in clinical manifestations between these 7 patients and 24 pure PMR patients.Through imaging examinations,we found that 9 of the 12 GCA patients had arterial stenosis,5 had thickened vascular walls,5 had atherosclerosis,and 2 had rough endometrium.Conclusion GCA patients and PMR may have similar clinical presentations.The presence of scalp pain,mandibular claudication and migraine during the course of the disease implies that GCA is more likely.Vascular ultrasound,arterial CTA,and positron emission tomograph(PET)/CT play an increasingly important role in the diagnosis of GCA.