Salvarani C, Cantini F, Boiardi L, Hunder G G
Rheumatology Service, Arcispedale S. Maria Nuova, V.le Umberto 1o N50, 42100 Reggio Emilia, Italy.
Clin Exp Rheumatol. 2003 Nov-Dec;21(6 Suppl 32):S23-8.
A raised erythrocyte sedimentation rate (ESR) is considered a hallmark for the diagnosis of giant cell arteritis (GCA). The American College of Rheumatology 1990 criteria for GCA include ESR greater than or equal to 50 mm/h as one of the five criteria. Although the presence of a normal ESR made GCA less likely, the results of a population-based study showed that the occurrence of a low/normal value in GCA at diagnosis is not rare. Pre-treatment ESR may be a prognostic indicator for duration of treatment. C-reactive protein (CRP) and interleukin-6 (IL-6) may be more sensitive indicators of disease activity than ESR in GCA patients. However, it is unclear whether the use in clinical practice of CRP and IL-6 has some apparent advantage over ESR. ESR is the most often used tool to assess disease activity in Takayasu's arteritis (TA). However, some studies have found that ESR and CRP are not able to differentiate patients with clinically active and inactive TA. Furthermore, histopathological studies have shown that over 40% of patients thought to be in clinical remission with normal acute phase reactants have active arteritis. IL-6 could be a promising marker of disease activity in TA; however, further studies are required to confirm its usefulness in clinical practice. Other laboratory investigations could be useful in the diagnosis or follow-up of GCA and TA, but more studies are required.
红细胞沉降率（ESR）升高被认为是巨细胞动脉炎（GCA）诊断的一个标志。美国风湿病学会1990年GCA诊断标准包括ESR大于或等于50mm/h作为五项标准之一。虽然ESR正常使GCA的可能性降低，但一项基于人群的研究结果表明，GCA诊断时出现低/正常ESR值并不罕见。治疗前ESR可能是治疗持续时间的一个预后指标。在GCA患者中，C反应蛋白（CRP）和白细胞介素-6（IL-6）可能比ESR更能敏感地反映疾病活动。然而，尚不清楚CRP和IL-6在临床实践中的应用是否比ESR具有明显优势。ESR是评估大动脉炎（TA）疾病活动最常用的工具。然而，一些研究发现，ESR和CRP无法区分临床活动期和非活动期的TA患者。此外，组织病理学研究表明，超过40%被认为处于临床缓解期且急性期反应物正常的患者存在活动性动脉炎。IL-6可能是TA疾病活动的一个有前景的标志物；然而，需要进一步研究以证实其在临床实践中的有用性。其他实验室检查可能对GCA和TA的诊断或随访有用，但还需要更多研究。
