Lagneau P, Michel J B, Vuong P N
Ann Surg. 1987 Feb;205(2):157-66. doi: 10.1097/00000658-198702000-00010.
Thirty-nine patients (mean age: 33 years) with Takayasu's disease were observed over the past 8 years. Among these patients, 33 had surgical intervention with a mean follow-up of 4 years. Lesions of the aortic arch were the most common (29 patients, 69 lesions) and frequently were associated with lesions in another site as well. However, in this group of patients, the infrequent presence of signs of cerebral vascular insufficiency limited the number of suitable surgical candidates to 14 patients. Lesions of the renal arteries were noted in 25 patients (37 lesions) and were associated with coarctation of the thoracoabdominal aorta in 12 patients. In contrast to lesions of the aortic arch, the presence of severe hypertension was a frequent indication for surgery in Takayasu's disease. Twenty-one patients had operation. Twenty of 21 patients were considered cured or improved of hypertension. The one patient who received no benefit was the only operative death of the study. In conclusion, although Takayasu's disease is progressive and the life expectancy is foreshortened, hypertension secondary to aortic and renal artery lesions is a frequent and important indication for aggressive operative treatment.
在过去8年中，对39例（平均年龄33岁）大动脉炎患者进行了观察。其中33例接受了手术干预，平均随访4年。主动脉弓病变最为常见（29例患者，69处病变），且常伴有其他部位病变。然而，在这组患者中，脑血管供血不足体征较少见，使得合适的手术候选者仅14例。25例患者发现肾动脉病变（37处病变），其中12例伴有胸主动脉缩窄。与主动脉弓病变不同，重度高血压是大动脉炎患者常见的手术指征。21例患者接受了手术。21例患者中有20例被认为高血压得到治愈或改善。唯一未获益的患者是本研究中唯一的手术死亡病例。总之，尽管大动脉炎呈进行性发展且预期寿命缩短，但主动脉和肾动脉病变继发的高血压是积极手术治疗的常见且重要指征。
