Luqmani R A
Scand J Rheumatol. 2000;29(4):211-5. doi: 10.1080/030097400750041334.
The evidence base for treatment of systemic vasculitis is reviewed in this article. Accurate diagnosis and evaluation of disease status is crucial to the appropriate management of these cases and disease status should be employed as a means of staging so that appropriate therapy can be offered tailored to the individual requirements of each case. Large vessel vasculitides are almost exclusively managed with corticosteroids. Small vessel vasculitis with internal organ involvement usually requires more aggressive immuno-suppression; by contrast, small vessel vasculitis without internal organ involvement rarely requires intervention. Despite our current efforts, the long-term morbidity of patients with systemic vasculitis remains high. We need better therapeutic strategies in order to limit or control disease rapidly and thereby prevent the accumulation of subsequent damage. Large-scale randomised trials comparing different therapeutic strategies offer the only hope of establishing a firmer evidence base for the optimal management of these diseases.
本文对系统性血管炎的治疗证据基础进行了综述。准确诊断和评估疾病状态对于这些病例的恰当管理至关重要，疾病状态应作为分期手段，以便能根据每个病例的个体需求提供合适的治疗。大血管血管炎几乎完全采用皮质类固醇进行治疗。累及内脏器官的小血管血管炎通常需要更积极的免疫抑制治疗；相比之下，未累及内脏器官的小血管血管炎很少需要干预。尽管我们目前做出了努力，但系统性血管炎患者的长期发病率仍然很高。我们需要更好的治疗策略，以便迅速限制或控制疾病，从而防止后续损害的累积。比较不同治疗策略的大规模随机试验是为这些疾病的最佳管理建立更坚实证据基础的唯一希望。
