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[结节性多动脉炎的诊断与临床病程]

[Diagnosis and clinical course of periarteritis nodosa].

作者信息

Budmiger H, Turina J, Streuli R, Bollinger A

出版信息

Schweiz Med Wochenschr. 1986 Nov 22;116(47):1634-9.

PMID:2879347
Abstract

The clinical symptoms, diagnostic procedure and course under treatment in 10 patients with polyarteritis nodosa are studied retrospectively. Clinically, 3 patients showed peripheral arterial occlusive disease in the lower extremities. 3 patients had evidence of preceding acute type B hepatitis. The diagnosis was confirmed by biopsy in 7 cases, by selective arteriography of the kidneys showing multiple small aneurysms in one case; in 2 patients the diagnosis was based upon the clinical findings only. Complete remission was achieved in 7 of 10 treated patients, in 5 patients with corticosteroids alone and in 2 patients with a combination of corticosteroids and cytotoxic agents. 4 patients died, one of them from vasculitis and 3 from other causes. 5-year survival for all patients was 52%. The diagnostic value of arteriography, the clinical picture of polyarteritis nodosa with peripheral arterial occlusive disease, and the association between hepatitis B infection and polyarteritis nodosa are discussed.

摘要

对10例结节性多动脉炎患者的临床症状、诊断方法及治疗过程进行了回顾性研究。临床上,3例患者表现为下肢外周动脉闭塞性疾病。3例患者有先前急性B型肝炎的证据。7例患者经活检确诊,1例经肾脏选择性动脉造影显示多发小动脉瘤确诊;2例患者仅根据临床表现确诊。10例接受治疗的患者中,7例完全缓解,5例仅用皮质类固醇实现缓解,2例联合使用皮质类固醇和细胞毒性药物实现缓解。4例患者死亡,其中1例死于血管炎,3例死于其他原因。所有患者的5年生存率为52%。讨论了动脉造影的诊断价值、伴有外周动脉闭塞性疾病的结节性多动脉炎的临床症状,以及乙型肝炎感染与结节性多动脉炎之间的关联。

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