Zheng Tie, Zhu Shuai, Ou Jia-Fu, Fang Wei-Gang, Qiao Zhi-Yu, Qi Rui-Dong, Chen Li, Chen Lei, Li Cheng-Nan, Pan Li-Li, Zhu Qing, Chen Dong, Sun Xue-Jun, Zhu Jun-Ming
a Department of Cardiovascular Surgery , Beijing Aortic Disease Center, Beijing Anzhen Hospital, Capital Medical University, Beijing, China, Beijing Institute of Heart Lung and Blood Vessel Diseases, Beijing Engineering Research Center for Vascular Prostheses , Beijing , China.
b Department of Cardiovascular Surgery , Beijing Aortic Disease Center, Beijing Anzhen Hospital, Capital Medical University , Beijing , China ; Beijing Institute of Heart Lung and Blood Vessel Diseases , Beijing , China.
J Invest Surg. 2019 Apr;32(3):220-227. doi: 10.1080/08941939.2017.1408718. Epub 2018 Jan 9.
To analyze the clinical outcome of corticosteroid and/or immunosuppressive treatment preoperatively in patients with Takayasu's arteritis.
Forty-six patients with Takayasu's arteritis who received cardiovascular surgery between January 2010 and December 2015 in Beijing Anzhen Hospital were enrolled in this study. Their clinical characteristics, preoperative drug therapy, surgical treatment, and pathological examination results were retrospectively analyzed for the effect of drugs on outcome of the surgery.
All 8 patients with active disease prior to surgery had postoperative complications including one death due to stubborn perivalvular regurgitation induced heart failure during the perioperative period. Among 38 patients without active disease prior to surgery, only 4 patients (10.5%) had postoperative complications. Thirty-four patients showed symptomatic relief in the perioperative period, of whom 23 patients treated with corticosteroid and/or immunosuppressive agents preoperatively.
The surgery can effectively improve the symptoms of patients with Takayasu's arteritis. Active disease of Takayasu's arteritis markedly increased risk for postoperative complication and resulted in poor outcome of the surgery. Treatment with corticosteroid and/or immunosuppressive agents before surgery can effectively control the patient's condition, improve the rate of remission, and effectively reduce the incidence of postoperative complications.
分析术前使用皮质类固醇和/或免疫抑制剂治疗对大动脉炎患者的临床疗效。
本研究纳入了2010年1月至2015年12月在北京安贞医院接受心血管手术的46例大动脉炎患者。回顾性分析了他们的临床特征、术前药物治疗、手术治疗及病理检查结果，以探讨药物对手术疗效的影响。
术前8例活动期患者术后均出现并发症，其中1例因顽固性瓣周反流导致心力衰竭，在围手术期死亡。术前38例非活动期患者中，仅4例（10.5%）出现术后并发症。34例患者围手术期症状缓解，其中23例术前接受了皮质类固醇和/或免疫抑制剂治疗。
手术可有效改善大动脉炎患者的症状。大动脉炎活动期显著增加术后并发症风险，导致手术效果不佳。术前使用皮质类固醇和/或免疫抑制剂治疗可有效控制患者病情，提高缓解率，有效降低术后并发症发生率。
