Berger C T, Wolbers M, Meyer P, Daikeler T, Hess C
Department of Internal Medicine, University Hospital Basel, Petersgraben 4, CH-4031 Basel, Switzerland.
Rheumatology (Oxford). 2009 Mar;48(3):258-61. doi: 10.1093/rheumatology/ken480. Epub 2009 Jan 7.
Vision loss and ischaemic stroke are feared complications in GCA. We investigated how platelet count and size and platelet inhibition with ASA relate to ischaemic complications in patients with GCA.
Charts of patients with GCA were retrospectively analysed. Jaw claudication, amaurosis fugax, blurred vision, ischaemic stroke and permanent visual loss were classified as 'ischaemic events'; ischaemic stroke and permanent visual loss were sub-grouped as 'severe ischaemic events'. The incidence of ischaemia and the association to the pre-defined covariates age, fever, ESR, platelet count and size and ASA treatment were assessed.
Eighty-five patients (mean age 73 yrs, 60% women, 78% biopsy-proven) were included in the analysis. Of the 85 patients, 62 (73%) presented with ischaemic events, 29/85 patients (34%) with severe ischaemic events. At the time of diagnosis 22/85 patients (26%) were treated with ASA. Of these 22 patients, 15 (68%) presented with ischaemic events, 7/22 patients (32%) with severe ischaemic events. In multivariate analysis, neither platelet count nor size or ASA treatment were significantly associated with ischaemic or severe ischaemic events.
The incidence of severe ischaemic events in patients with GCA was high, irrespective of platelet count and size and established ASA treatment.
视力丧失和缺血性中风是巨细胞动脉炎（GCA）中令人担忧的并发症。我们研究了血小板计数、大小以及阿司匹林（ASA）对血小板的抑制作用与GCA患者缺血性并发症之间的关系。
对GCA患者的病历进行回顾性分析。将颌部间歇性运动障碍、一过性黑矇、视力模糊、缺血性中风和永久性视力丧失归类为“缺血性事件”；缺血性中风和永久性视力丧失被进一步归类为“严重缺血性事件”。评估缺血的发生率以及与预先定义的协变量年龄、发热、红细胞沉降率（ESR）、血小板计数、大小和ASA治疗之间的关联。
85例患者（平均年龄73岁，60%为女性，78%经活检证实）纳入分析。85例患者中，62例（73%）出现缺血性事件，29/85例患者（34%）出现严重缺血性事件。诊断时，22/85例患者（26%）接受了ASA治疗。在这22例患者中，15例（68%）出现缺血性事件，7/22例患者（32%）出现严重缺血性事件。多变量分析显示，血小板计数、大小或ASA治疗与缺血性或严重缺血性事件均无显著关联。
GCA患者严重缺血性事件的发生率较高，与血小板计数、大小及既定的ASA治疗无关。
