Hong C Y, Yun Y S, Choi J Y, Sul J H, Lee K S, Cha S H, Hong Y M, Lee H J, Hong Y J, Sohn K C
Department of Pediatrics, Seoul National University, Korea.
Heart Vessels Suppl. 1992;7:91-6. doi: 10.1007/BF01744551.
Seventy cases of Takayasu arteritis in Korean children are reported. There were 57 females and 13 males (male-to-female ratio; 1:4.4). The youngest patient was a 3-year-old female. Family history was positive in one patient. The most common chief complaints on admission were dyspnea, headache, palpitation, and edema which were due to hypertension and congestive heart failure. Hypertension was seen in 65 out of 70 patients (92.8%). The abdominal aorta, thoracic aorta, and renal arteries were the most commonly involved sites in these children. Two patients had nephrotic syndrome. The frequency of positive tuberculin reaction was much higher in children with Takayasu arteritis compared with the general population, and the intensity of the reaction was also stronger. The majority of the patients required immediate medical treatment to control congestive heart failure due to hypertension at initial presentation. When ESR was elevated, corticosteroid was administered. Surgical treatment showed good results in six out of ten cases. Percutaneous intraluminal angioplasty was effective for lowering the blood pressure in six out of nine cases. In three cases, restenosis occurred and angioplasty was repeated in two cases.
本文报道了70例韩国儿童大动脉炎病例。其中女性57例,男性13例(男女性别比为1:4.4)。最年幼的患者为一名3岁女性。1例患者有家族病史。入院时最常见的主要症状是呼吸困难、头痛、心悸和水肿,这些症状由高血压和充血性心力衰竭引起。70例患者中有65例(92.8%)出现高血压。腹主动脉、胸主动脉和肾动脉是这些儿童最常受累的部位。2例患者患有肾病综合征。与普通人群相比,大动脉炎患儿结核菌素反应阳性的频率更高,且反应强度也更强。大多数患者在初次就诊时需要立即进行药物治疗以控制高血压所致的充血性心力衰竭。当血沉升高时,给予皮质类固醇治疗。手术治疗在10例中有6例效果良好。经皮腔内血管成形术在9例中有6例能有效降低血压。3例出现再狭窄,其中2例再次进行了血管成形术。