Department of Cardiovascular Medicine, Tokyo Medical and Dental University, Tokyo, Japan.
Circ J. 2012;76(4):1004-11. doi: 10.1253/circj.cj-11-1108. Epub 2012 Feb 2.
We aimed to describe the recent clinical characteristics of Takayasu arteritis (TA).
We enrolled 106 consecutive TA patients and compared the clinical characteristics of patients with TA onset before 1999 and after 2000, patients with onset at age less than 39 years and more than 40 years, patients with monophasic and relapsing-remitting clinical course, and patients with and without human lymphocyte antigen (HLA)-B52 allele. Among the patients with TA onset after 2000, the time from onset to diagnosis had decreased; the frequency of occlusion in aortic arch branches and the complication of moderate or severe aortic regurgitation (AR) had decreased, and the maximum dose of prednisolone and the use of immunosuppressive agents had increased. In patients with onset at age more than 40 years, the complications of coronary artery lesions and hypertension had increased, and the incidence of moderate or severe AR had decreased. In the relapsing-remitting group, the maximum dose of prednisolone and the use of immunosuppressive agents had increased, and the mean dose reduction rate of prednisolone was significantly high. There was no significant difference between patients with and without HLA-B52 allele.
The prognosis of TA patients has improved over the past decade, which may be related to early diagnosis because of the development of noninvasive diagnostic imaging tools and improved medical treatments.
本研究旨在描述大动脉炎（TA）的近期临床特征。
我们纳入了 106 例连续的 TA 患者，并比较了 1999 年之前和之后发病、发病年龄小于 39 岁和大于 40 岁、单发性和复发缓解性病程以及是否携带人类白细胞抗原（HLA）-B52 等位基因的患者的临床特征。在 2000 年后发病的患者中，从发病到确诊的时间缩短；主动脉弓分支闭塞和中重度主动脉瓣反流（AR）的发生率降低，泼尼松龙的最大剂量和免疫抑制剂的使用增加。发病年龄大于 40 岁的患者中，冠状动脉病变和高血压的并发症增加，中重度 AR 的发生率降低。在复发缓解组中，泼尼松龙的最大剂量和免疫抑制剂的使用增加，且泼尼松龙的平均减药率显著较高。是否携带 HLA-B52 等位基因之间无显著差异。
在过去十年中，TA 患者的预后有所改善，这可能与非侵入性诊断影像学工具的发展和医疗水平的提高有关，从而有助于更早地诊断。
