Schirmer M, Dejaco C, Schmidt W A
Labor für Molekulare Biologie und Rheumatologie, Allgemeine Ambulanz und Rheumaambulanz, Univ.-Klinik für Innere Medizin I, Medizinische Universität Innsbruck, Anichstr. 35, 6020, Innsbruck, Österreich.
Z Rheumatol. 2012 Nov;71(9):754-9. doi: 10.1007/s00393-012-0983-y.
Giant-cell arteritis (GCA) is the most common form of vasculitis in patients over 50 years old. Loss of vision is the most common severe complication but involvement of extracranial arteries including the aorta is more frequent than previously assumed. The role of dendritic and T-cells indicates the presence of an antibody but a clear association with underlying infections has not yet been demonstrated. Even if the inflammation parameters in blood are mostly increased in the diagnosis of GCA, specific laboratory tests for the diagnosis of GCA are not available. Of the imaging procedures ultrasonography, magnetic resonance imaging and (18)F-fluorodeoxyglucose positron emission tomography can be useful to localize and estimate the extent of vascular involvement. Glucocorticoids are still the standard therapy of GCA, whereby the cumulative dose can possibly be reduced by additional methotrexate. In addition acetylsalicylic acid is recommended as prophylaxis against cardiovascular and cerebrovascular events as well as prophylaxis and therapy of accompanying osteoporosis.
巨细胞动脉炎（GCA）是50岁以上患者中最常见的血管炎形式。视力丧失是最常见的严重并发症，但包括主动脉在内的颅外动脉受累比以前认为的更为频繁。树突状细胞和T细胞的作用表明存在抗体，但尚未证明与潜在感染有明确关联。即使在GCA诊断中血液中的炎症参数大多升高，但尚无用于GCA诊断的特异性实验室检查。在成像检查中，超声检查、磁共振成像和（18）F-氟脱氧葡萄糖正电子发射断层扫描有助于定位和评估血管受累程度。糖皮质激素仍然是GCA的标准治疗方法，额外使用甲氨蝶呤可能会降低累积剂量。此外，推荐使用乙酰水杨酸预防心血管和脑血管事件以及预防和治疗伴随的骨质疏松症。
