颞动脉炎47例临床资料分析

目的总结颞动脉炎的临床特征及病理改变。方法收集国内报告的44例及本院治疗的3例。共47例(其中29例进行活检)资料进行分析。结果头痛46例(97.9%);视力障碍12例(25.5%);低热(6/14,42.9%);脑神经麻痹13例(27.7%),其中动眼神经8例、外展神经2例、面神经2例、听神经1例;合并风湿性多肌痛6例;合并脑梗死5例、脑出血2例。血沉80.6%(29/36)增快,C反-应蛋白71.4%(5/7)增高。颞动脉均增粗、变硬。颞动脉活检29例,28例证实为颞动脉炎。皮质内固醇治疗效果良好。结论颞动脉炎临床并不十分罕见,掌握其临床特征,多可诊断。颞动脉活检可确诊,皮质类固醇治疗效果良好。

Temporal arteritis:Analysis of 47 cases

Objective To summarize the clinical manifestations and pathological changes of temporal arteritis.Methods 3 cases from First Hospital of Jilin University and 44 cases reported in domestic literature were analyzed.The pathological changes of 29 cases were summarized too.Results The main clinical manifestations included headache in 46 cases(97.9%),vision disturbance in 12 cases(25.5%),and low fever in 6 cases of 14 ones with records(42.9%).Disorders of cerebral nerves were found in 13 cases(27.7%),among them,8 cases with disorder of oculomotor nerve,2 cases,abducent nerve,2 cases,facial nerve and 1 case,auditory nerve.At the same time,6 cases complicated with polymyalgia rheumatica,5 cases with stroke and 2 cases with cerebral hemorrhage.Laboratory tests showed that 29 of 36 cases with records(80.6%) had increased blood sedimentation rate,and 5 of 7 cases with records(71.4%) had higher level of C-reactive protein.All patients showed thickening and projected temporal arteries.In 29 cases with biospy,28 cases were pathologically definited.The inflammatory cell infiltrates in the wall and the tissues surrounding the temporal artery were observed.Early steroid hormone treatment showed good effect.Conclusion Temporal arteritis is not rare in clinic,and the characteristic clinical manifestations should be noticed.Biospy of temporal arteries can provide difinited diagnosis.Treatment with steroid hormone has satisfactory effect.