Eklund Kari K, Pettersson Tom
Helsingin Reumakeskus, Bulevardi 22, 00120 Helsinki.
Duodecim. 2011;127(15):1539-47.
Temporal arteritis (giant cell arteritis), and Takayasu's arteritis are the two primary large-vessel vasculitides. Both are characterized by activation of the adaptive immune system in the vessel wall and activation of the innate immune system, manifesting as systemic inflammatory symptoms and an acute phase reaction. The clinical findings in temporal arteritis commonly include visual loss, headache, scalp tenderness, jaw claudication and polymyalgia rheumatica. Takayasu's arteritis begins with non-specific symptoms followed by decreased perfusion of the extremities, internal organs and brain as the disease progresses to vessel narrowing. Temporal artery biopsy is the gold standard for diagnosing temporal arteritis, whereas the diagnosis of Takayasu's arteritis relies on magnetic angiography or computed tomography angiography of the aorta and its branches. Glucocorticoids are the cornerstone of treatment of both diseases. In selected cases of Takayasu's arteritis methotrexate and tumour necrosis factor inhibitors have proved useful.
颞动脉炎（巨细胞动脉炎）和高安动脉炎是两种主要的大血管血管炎。两者的特征均为血管壁中适应性免疫系统的激活以及先天性免疫系统的激活，表现为全身炎症症状和急性期反应。颞动脉炎的临床症状通常包括视力丧失、头痛、头皮压痛、颌部间歇性运动障碍和风湿性多肌痛。高安动脉炎起病时症状不具特异性，随着病情发展至血管狭窄，会出现四肢、内脏器官和脑部灌注减少的情况。颞动脉活检是诊断颞动脉炎的金标准，而高安动脉炎的诊断则依赖于主动脉及其分支的磁共振血管造影或计算机断层血管造影。糖皮质激素是这两种疾病治疗的基石。在高安动脉炎的某些特定病例中，甲氨蝶呤和肿瘤坏死因子抑制剂已被证明有效。
