Klein R G, Hunder G G, Stanson A W, Sheps S G
Ann Intern Med. 1975 Dec;83(6):806-12. doi: 10.7326/0003-4819-83-6-806.
Of 248 patients with giant cell arteritis, 34 had evidence that the disease affected the aorta or its major branches. Symptoms suggestive of large artery involvement were intermittent claudication of an extremity, paresthesias, and Raynaud's phenomenon. Physical findings included absent or decreased large artery pulses and bruits over large arteries. Four patients presented with decreased upper extremity pulses as the initial manifestation of their arteritis. Nine other patients under treatment for temporal arteritis or polymyalgia rheumatica first developed evidence of large artery involvement as corticosteroid therapy was tapered or discontinued. Angiography, performed in 10 patients, was helpful in indicating arteritis rather than atherosclerosis as the cause of large artery disease. Three patients died with aortic rupture, and, at autopsy, widespread giant cell arteritis was found. However, when corticosteroids were given in adequate doses, the response was favorable in most patients; intermittent claudication decreased and the pulses improved.
在248例巨细胞动脉炎患者中，34例有证据表明疾病累及主动脉或其主要分支。提示大动脉受累的症状包括肢体间歇性跛行、感觉异常和雷诺现象。体格检查发现包括大动脉搏动消失或减弱以及大动脉处出现血管杂音。4例患者以上肢脉搏减弱作为动脉炎的首发表现。另外9例正在接受颞动脉炎或风湿性多肌痛治疗的患者，在糖皮质激素治疗逐渐减量或停药时，首次出现大动脉受累的证据。对10例患者进行了血管造影，有助于明确动脉炎而非动脉粥样硬化是大动脉疾病的病因。3例患者死于主动脉破裂，尸检发现广泛的巨细胞动脉炎。然而，当给予足够剂量的糖皮质激素时，大多数患者反应良好；间歇性跛行减轻，脉搏改善。
