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大动脉炎患儿肾血管疾病的管理

Management of the renovascular disease in children with Takayasu arteritis.

作者信息

Tullus Kjell

机构信息

Karolinska Institute, Stockholm, Sweden,

出版信息

Pediatr Nephrol. 2015 Aug;30(8):1213-6. doi: 10.1007/s00467-015-3093-7. Epub 2015 May 16.

Abstract

Takaysu arteritis (TA), together with fibromuscular dysplasia, is the most common cause for renovascular hypertension. The diagnosis of vasculitis is important to make as these children benefit from immunosuppressive treatment. In many cases, however, it is more difficult than commonly realised to differentiate between these two diagnoses. Imaging which allows the inflamed arterial wall to be outlined, such as magnetic resonance or positron emission tomography scans, can be very helpful in this context. Revascularisation, either with angioplasty or surgery, seems to be effective and safe, also in children with TA. Patients with inactive disease have a more successful outcome and experience fewer complications from the intervention than those with active on-going inflammation.

摘要

高安动脉炎(TA)与纤维肌发育不良一起,是肾血管性高血压最常见的病因。血管炎的诊断很重要,因为这些儿童可从免疫抑制治疗中获益。然而,在许多情况下,区分这两种诊断比通常意识到的要困难得多。在这种情况下,能够勾勒出炎症动脉壁的成像检查,如磁共振成像或正电子发射断层扫描,会非常有帮助。血管成形术或手术等血管重建术似乎对TA患儿也是有效且安全的。与处于活动性炎症期的患者相比,疾病处于非活动期的患者干预后结局更成功,并发症也更少。

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