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Takayasu 动脉炎:诊断、治疗与预后。

Takayasu arteritis: diagnosis, treatment and prognosis.

机构信息

Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Diseases, China.

出版信息

Int Rev Immunol. 2012 Dec;31(6):462-73. doi: 10.3109/08830185.2012.740105.

Abstract

Takayasu arteritis (TA) is a chronic nonspecific granulomatous vasculitis affecting aorta and its main branches, coronary and pulmonary arteries. TA often occurs in young women and has a characteristic heterogeneity depending on ethnicity and geographical location. Although the pathogenesis of TA remains unclear, the interaction of many factors, such as autoimmunity, inflammation, genetic and environmental factors and so on, is involved in the occurrence and development of TA. Angiography, which is recognized as the gold standard in evaluating vascular lesions in TA, combined with computer tomography angiography (CTA), magnetic resonance angiography (MRA), ultrasonography, (18)Fluorodeoxyglucose positron emission tomography ((18)F-FDG-PET) could not only provide important information for early diagnosis but also detect disease activity, and thus further guide the treatment in TA. In addition, beside the commonly used corticosteroids, immunosuppressive agents, percutaneous transluminal angioplasty (PTA) and surgical revascularization, anti-tumor necrosis factor (TNF) agent has been more widely used in refractory cases of TA. The objective of this review is to systemically describe the pathogenesis, clinical characteristics, diagnosis, treatment and prognosis of TA.

摘要

Takayasu 动脉炎(TA)是一种影响主动脉及其主要分支、冠状动脉和肺动脉的慢性非特异性肉芽肿性血管炎。TA 常发生于年轻女性,具有明显的异质性,取决于种族和地理位置。虽然 TA 的发病机制仍不清楚,但许多因素的相互作用,如自身免疫、炎症、遗传和环境因素等,参与了 TA 的发生和发展。血管造影被认为是评估 TA 血管病变的金标准,结合计算机断层血管造影(CTA)、磁共振血管造影(MRA)、超声、(18)氟脱氧葡萄糖正电子发射断层扫描((18)F-FDG-PET)不仅可以为早期诊断提供重要信息,还可以检测疾病活动,从而进一步指导 TA 的治疗。此外,除了常用的皮质类固醇、免疫抑制剂、经皮腔内血管成形术(PTA)和手术血运重建外,抗肿瘤坏死因子(TNF)药物在 TA 的难治性病例中也得到了更广泛的应用。本综述的目的是系统描述 TA 的发病机制、临床特征、诊断、治疗和预后。

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