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三家大学医院对高安动脉炎患者的临床、实验室及影像学表现和并发症的十年调查

Ten-year Investigation of Clinical, Laboratory and Radiologic Manifestations and Complications in Patients with Takayasu's Arteritis in Three University Hospitals.

作者信息

Nooshin Dalili, Neda Pazhouhi, Shahdokht Samangooyi, Ali Jamalian

机构信息

Taleghani University Hospital, Shahid Beheshti University of Medical Sciences, Velenjak, Yaman street, P.O Box 1911677913, Tehran, Iran.

出版信息

Malays J Med Sci. 2013 May;20(3):44-50.

Abstract

BACKGROUND

Takayasu arteritis is a condition of unknown aetiology that affects the aorta and its primary branches. The disease has been primarily recognized and described in Asia. The aims of this study were to identify the main clinical, laboratory, and angiographic features of Takayasu arteritis in Iranian patients over a 10 year period from 2000 to 2010.

METHODS

Data were obtained from angiographic and medical records of patients treated at Shahid-Rajai, Taleghani, and Loghman Hospitals during the above-mentioned time period. The criteria for definitions and findings were those proposed by the American College of Rheumatology.

RESULTS

A total of 15 patients were identified. The median age at presentation was 36 years and 73.3% of patients were females. Fever was the most common presentation. According to "modified" National Institute of Health criteria, 44.7% of patients were in the acute phase of disease with systemic symptoms such as fever, weight loss, and elevated C-reactive protein (CRP) levels. Immunological markers such as antinuclear antibodies (ANA) and antineutrophil cytoplasmic antibodies (C-ANCA) were absent. The tuberculin test result was positive in 40% of the patients. Vascular bruit was present in 86.7% and hypertension was detected in 53.3% with 13.3% having associated renal artery stenosis. The angiographic manifestations were classified as; type I, cervicobrachial type (26.6%); type II, thoracoabdominal type (20.0%); type III, peripheral type (6.6%); and type IV, generalised type (46.7%). Coronary arteries were involved in three cases, pulmonary in two and renal in two.

CONCLUSION

Based on our findings, the most common clinical, laboratory and angiographic findings were fever, increased erythrocyte sedimentation rate (ESR) and stenosis, respectively. Because of dangerous consequences of this disease, attention to fever and increased ESR, especially in young women may be helpful for physicians to prevent diagnosis delay.

摘要

背景

大动脉炎是一种病因不明的疾病,累及主动脉及其主要分支。该病最初在亚洲被认识和描述。本研究的目的是确定2000年至2010年期间伊朗患者大动脉炎的主要临床、实验室和血管造影特征。

方法

数据来自上述时间段内在沙希德 - 拉贾伊、塔莱加尼和洛格曼医院接受治疗的患者的血管造影和医疗记录。定义和发现的标准采用美国风湿病学会提出的标准。

结果

共确定了15例患者。就诊时的中位年龄为36岁,73.3%的患者为女性。发热是最常见的表现。根据“改良”的美国国立卫生研究院标准,44.7%的患者处于疾病急性期,伴有发热、体重减轻和C反应蛋白(CRP)水平升高等全身症状。抗核抗体(ANA)和抗中性粒细胞胞浆抗体(C-ANCA)等免疫标志物均未出现。40%的患者结核菌素试验结果呈阳性。86.7%的患者有血管杂音,53.3%的患者检测到高血压,其中13.3%伴有肾动脉狭窄。血管造影表现分类为:I型,颈臂型(26.6%);II型,胸腹型(20.0%);III型,周围型(6.6%);IV型,全身型(46.7%)。3例累及冠状动脉,2例累及肺部,2例累及肾脏。

结论

根据我们的研究结果,最常见的临床、实验室和血管造影表现分别为发热、红细胞沉降率(ESR)升高和狭窄。由于该病的危险后果,关注发热和ESR升高,尤其是年轻女性,可能有助于医生避免诊断延迟。

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Rheumatology (Oxford). 2009 Aug;48(8):1008-11. doi: 10.1093/rheumatology/kep153. Epub 2009 Jun 19.
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[Takayasu arteritis in southern Tunisia: a study of 29 patients].突尼斯南部的高安动脉炎:29例患者的研究
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