Watts Richard A, Lane Suzanne, Scott David G I
Department of Rheumatology, Norfolk and Norwich University Hospital NHS Trust, UK.
Best Pract Res Clin Rheumatol. 2005 Apr;19(2):191-207. doi: 10.1016/j.berh.2004.11.006.
The vasculitides are conditions of unknown aetiology. Until recently, relatively little was known about their incidence and prevalence, but there are now increasing data, especially from Europe. These are conditions of the extremes of age. Kawasaki disease occurs predominately in Asian children, with a peak annual incidence of 90/100,000 children aged under 5 years. Henoch-Schonlein purpura has an incidence of 70/100,000 in those aged 4-7 years and is also more common in Asians. Primary systemic vasculitis has a peak incidence 6/100,000 in those aged 65-74 years. Giant cell arteritis is most common in Caucasians aged over 70 years, with an incidence of 53/100,000. Vasculitis has been associated with malignancy, the association being strongest between haematological malignancies and cutaneous vasculitis. There is occasionally a temporal association; failure to respond appropriately to therapy should prompt a search for malignancy. Lesions suspicious of malignancy should be biopsied even if the diagnosis of vasculitis has been histologically proven.
血管炎是病因不明的疾病。直到最近,人们对其发病率和患病率了解相对较少,但现在有越来越多的数据,尤其是来自欧洲的数据。这些疾病好发于年龄极端的人群。川崎病主要发生在亚洲儿童中,5岁以下儿童的年发病率峰值为每10万人中有90例。过敏性紫癜在4至7岁人群中的发病率为每10万人中有70例,在亚洲人中也更为常见。原发性系统性血管炎在65至74岁人群中的发病率峰值为每10万人中有6例。巨细胞动脉炎在70岁以上的白种人中最为常见,发病率为每10万人中有53例。血管炎与恶性肿瘤有关,血液系统恶性肿瘤与皮肤血管炎之间的关联最为密切。偶尔存在时间上的关联;对治疗反应不佳应促使排查恶性肿瘤。即使血管炎的诊断已通过组织学证实,可疑恶性肿瘤的病变也应进行活检。