Shelhamer J H, Volkman D J, Parrillo J E, Lawley T J, Johnston M R, Fauci A S
Ann Intern Med. 1985 Jul;103(1):121-6. doi: 10.7326/0003-4819-103-1-121.
Twenty patients with Takayasu's arteritis were followed prospectively for an average of 4.6 years. Sixteen patients with active inflammatory Takayasu's arteritis were treated with glucocorticosteroids; eight responded to therapy. Six patients had clinical or angiographic progression of their vasculitis on daily corticosteroid therapy. These patients were then given cyclophosphamide together with prednisone on alternate days. Four of these 6 patients had no progression of vascular lesions while receiving cyclophosphamide; two had progression of vascular lesions after 30 and 48 months of therapy. Vascular reconstructive surgery was successful in 7 patients who tolerated a total of 13 vascular surgical procedures without major complications. One bypass graft occluded after 13 months and was revised. With corticosteroid therapy, cytotoxic therapy, and surgery, no deaths due to Takayasu's arteritis or its treatment have occurred.
对20例大动脉炎患者进行了平均4.6年的前瞻性随访。16例活动性炎症性大动脉炎患者接受了糖皮质激素治疗；其中8例对治疗有反应。6例患者在每日使用糖皮质激素治疗时出现血管炎的临床或血管造影进展。这些患者随后隔天给予环磷酰胺联合泼尼松治疗。这6例患者中有4例在接受环磷酰胺治疗时血管病变无进展；2例在治疗30个月和48个月后血管病变出现进展。7例患者接受了血管重建手术，共耐受了13次血管外科手术，无重大并发症。1例搭桥移植血管在13个月后闭塞并进行了修复。通过糖皮质激素治疗、细胞毒性治疗和手术，未发生因大动脉炎或其治疗导致的死亡。
