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不同种族背景的高安动脉炎的患病率、发病率及疾病特征:来自挪威南部一个大型人群队列的数据

Prevalence, Incidence, and Disease Characteristics of Takayasu Arteritis by Ethnic Background: Data From a Large, Population-Based Cohort Resident in Southern Norway.

作者信息

Gudbrandsson Birgir, Molberg Øyvind, Garen Torhild, Palm Øyvind

机构信息

University of Oslo, Oslo, Norway.

University of Oslo and Oslo University Hospital, Oslo, Norway.

出版信息

Arthritis Care Res (Hoboken). 2017 Feb;69(2):278-285. doi: 10.1002/acr.22931. Epub 2016 Dec 31.

Abstract

OBJECTIVE

To study the epidemiology and clinical characteristics of Takayasu arteritis (TAK) in southeast Norway (population 2.8 million).

METHODS

All study area hospital databases were screened to capture every potential TAK case between 1999 and 2012. These cases were manually chart reviewed, and only patients fulfilling either the 1990 American College of Rheumatology classification or the 1995 Ishikawa diagnostic criteria were included.

RESULTS

Inclusion criteria were met by 78 patients (68 female, 10 male). Point prevalence (by 2012) segregated by ethnic origin was 22.0 per 10 (95% confidence interval [95% CI] 17-29) in northern Europeans compared to 78.1 (95% CI 38-152) in Asian whites and 108.3 (95% CI 46-254) in Africans (P < 0.001). The incidence rate increased from 1 to 2 per 10 in the first to last 5-year period of the study (P = 0.03). Northern Europeans were mean age 32.3 years at onset, and 47% had involvement confined to aortic arch branches (angiographic type I), while 24% had extensive type V disease. Mean onset age in Asian and African cases was 20.3 years and 47% had type V disease. Coexisting inflammatory bowel disease was observed in 8% and ankylosing spondylitis in 7%.

CONCLUSION

We report 2-4 times higher population prevalence than previously observed, and the highest prevalence ever found in Norwegians of Asian and African descent. The results support the idea that TAK in northern Europeans is marked by limited arterial involvement and older age at onset.

摘要

目的

研究挪威东南部(人口280万)大动脉炎(TAK)的流行病学及临床特征。

方法

筛查研究区域内所有医院数据库,以获取1999年至2012年间每一例可能的TAK病例。对这些病例进行人工病历审查,仅纳入符合1990年美国风湿病学会分类标准或1995年石川诊断标准的患者。

结果

78例患者(68例女性,10例男性)符合纳入标准。按种族划分,2012年北欧人的点患病率为每10万人中22.0例(95%置信区间[95%CI]17 - 29),亚洲白人中为78.1例(95%CI 38 - 152),非洲人中为10,8.3例(95%CI 46 - 254)(P < 0.001)。研究的第一个5年期间至最后一个5年期间,发病率从每10万人中1例增至2例(P = 0.03)。北欧患者发病时的平均年龄为32.3岁,47%的患者病变局限于主动脉弓分支(血管造影I型),而24%的患者为广泛的V型病变。亚洲和非洲患者的平均发病年龄为20.3岁,47%的患者为V型病变。8%的患者合并炎症性肠病,7%的患者合并强直性脊柱炎。

结论

我们报告的人群患病率比之前观察到的高2至4倍,且在挪威亚裔和非裔中发现了有史以来最高的患病率。结果支持这样的观点,即北欧人的TAK特点是动脉受累有限且发病年龄较大。

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