Slobodin G, Naschitz J E, Zuckerman E, Zisman D, Rozenbaum M, Boulman N, Rosner I
Department of Internal Medicine A, Bnai Zion Medical Center, Technion, Haifa, Israel.
Clin Exp Rheumatol. 2006 Mar-Apr;24(2 Suppl 41):S41-7.
To review the prevalence, mechanisms, presentations and clinical significance of aortic involvement in rheumatic inflammatory diseases.
The medical literature, available through a PUBMED search was reviewed and the relevant information was summarized. In addition, selected articles related to aortic involvement in rheumatic diseases were included in this review.
Rheumatic disorders may be categorized by their propensity to involve the aorta: conditions with a prevalence of 10% and more (Takayasu's arteritis, temporal arteritis, long-standing ankylosing spondylitis, Cogan's syndrome and relapsing polychondritis), disorders with uncommon but well documented aortic involvement and rheumatic conditions with rare case reports of such involvement. Clinical presentation of aortic disease is dependent on the part of aorta involved and may manifest by aortic pain and/or other symptoms caused by aortic dilatation, narrowing or aneurysm. The histopathology of inflammatory aortitis is characterized by lymphoplasmacytic infiltration with or without giant cells or granulomas. On the other hand, non-inflammatory aortic damage in rheumatic diseases may include Marfan-like cystic disintegration of the aortic media as well as accelerated atherosclerosis. Awareness of rheumatic conditions with a high potential for clinically significant aortic involvement may promote referral of such patients for aortic imaging and sometimes surgery before fatal complications intervene.
Early diagnosis of aortic involvement can be advanced by informed consideration of such a complication in a rheumatic patient.
综述风湿性炎症性疾病中主动脉受累的患病率、机制、表现及临床意义。
通过检索PUBMED查阅医学文献并总结相关信息。此外，本综述纳入了与风湿性疾病中主动脉受累相关的精选文章。
风湿性疾病可根据其累及主动脉的倾向进行分类：患病率达10%及以上的疾病（高安动脉炎、颞动脉炎、长期强直性脊柱炎、科根综合征和复发性多软骨炎）、主动脉受累虽不常见但有充分文献记载的疾病以及仅有罕见病例报告主动脉受累的风湿性疾病。主动脉疾病的临床表现取决于主动脉受累部位，可表现为主动脉疼痛和/或由主动脉扩张、狭窄或动脉瘤引起的其他症状。炎症性主动脉炎的组织病理学特征为淋巴细胞和浆细胞浸润，可伴有或不伴有巨细胞或肉芽肿。另一方面，风湿性疾病中的非炎症性主动脉损害可能包括主动脉中层类似马方综合征的囊性崩解以及动脉粥样硬化加速。认识到具有临床显著主动脉受累高风险的风湿性疾病，可能会促使此类患者在致命并发症发生前接受主动脉成像检查，有时还会接受手术治疗。
通过对风湿性患者中此类并发症的明智考虑，可推动主动脉受累的早期诊断。
