Epperly T D, Moore K E, Harrover J D
Department of Family and Community Medicine, Eisenhower Army Medical Center, Fort Gordon, Georgia 30905-5650, USA.
Am Fam Physician. 2000 Aug 15;62(4):789-96, 801.
Polymyalgia rheumatica and temporal arteritis are closely related inflammatory conditions that affect different cellular targets in genetically predisposed persons. Compared with temporal arteritis, polymyalgla rheumatica is much more common, affecting one in 200 persons older than 50 years. Temporal arteritis, however, is more dangerous and can lead to sudden blindness. The diagnosis of polymyalgia rheumatica is based on the presence of a clinical syndrome consisting of fever, nonspecific somatic complaints, pain and stiffness in the shoulder and pelvic girdles, and an elevated erythrocyte sedimentation rate. Temporal arteritis typically presents with many of the same findings as polymyalgia rheumatica, but patients also have headaches and tenderness to palpation over the involved artery. Arterial biopsy usually confirms the diagnosis of temporal arteritis. Early diagnosis and treatment of polymyalgia rheumatica or temporal arteritis can dramatically improve patients' lives and return them to previous functional status. Corticosteroid therapy provides rapid and dramatic improvement of the clinical features of both conditions. Therapy is generally continued for six to 24 months. Throughout treatment, clinical condition is assessed periodically. Patients are instructed to see their physician immediately if symptoms recur or they develop new headache, jaw claudication or visual problems.
风湿性多肌痛和颞动脉炎是密切相关的炎症性疾病，在具有遗传易感性的人群中影响不同的细胞靶点。与颞动脉炎相比，风湿性多肌痛更为常见，在50岁以上人群中发病率为1/200。然而，颞动脉炎更危险，可导致突然失明。风湿性多肌痛的诊断基于存在由发热、非特异性躯体不适、肩部和骨盆带疼痛及僵硬，以及红细胞沉降率升高组成的临床综合征。颞动脉炎通常表现出许多与风湿性多肌痛相同的症状，但患者还会出现头痛以及受累动脉触痛。动脉活检通常可确诊颞动脉炎。风湿性多肌痛或颞动脉炎的早期诊断和治疗可显著改善患者生活，并使其恢复至先前的功能状态。皮质类固醇疗法可使这两种疾病的临床症状迅速且显著改善。治疗通常持续6至24个月。在整个治疗过程中，定期评估临床状况。如果症状复发或出现新的头痛、颌部跛行或视觉问题，患者需立即就医。
