Nordborg E, Nordborg C, Bengtsson B A
Sahlgrenska Hospital, Göteborg, Sweden.
Curr Opin Rheumatol. 1992 Feb;4(1):23-30.
Giant cell arteritis is a generalized inflammatory disorder involving large and medium-sized arteries. The etiology is unknown, although an autoimmune pathogenesis seems probable. In view of the clinical similarities between patients with positive biopsy findings for polymyalgia rheumatica and those with negative biopsy findings, many authors favor the concept that polymyalgia rheumatica is an expression of an underlying giant cell arteritis. There is, however, still controversy as to whether polymyalgia rheumatica and temporal arteritis are different expressions of one and the same disease or two separate, partly overlapping types of giant cell arteritis. A single etiologic factor may be responsible for the two conditions, sometimes expressing itself as polymyalgia rheumatica and sometimes as giant cell arteritis. Recent findings of morphologic similarities in terms of arterial wall atrophy, calcifications, and inflammatory reactions may indicate that polymyalgia rheumatica and temporal arteritis represent different degrees or stages of the same disease.
巨细胞动脉炎是一种累及大中动脉的全身性炎症性疾病。病因不明，不过自身免疫发病机制似乎很有可能。鉴于风湿性多肌痛活检结果阳性的患者与活检结果阴性的患者在临床上有相似之处，许多作者赞成这样的观点，即风湿性多肌痛是潜在巨细胞动脉炎的一种表现形式。然而，风湿性多肌痛和颞动脉炎究竟是同一种疾病的不同表现，还是两种独立的、部分重叠的巨细胞动脉炎类型，目前仍存在争议。单一病因可能导致这两种情况，有时表现为风湿性多肌痛，有时表现为巨细胞动脉炎。最近在动脉壁萎缩、钙化和炎症反应方面形态学相似性的发现可能表明，风湿性多肌痛和颞动脉炎代表了同一种疾病的不同程度或阶段。
