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巨细胞动脉炎相关大动脉炎伴或不伴颞动脉活检阳性:一项法国多中心研究。

Giant cell arteritis-related aortitis with positive or negative temporal artery biopsy: a French multicentre study.

机构信息

Department of Internal Medicine, University Hospital of Nantes, Nantes University, Nantes, France.

Department of Internal Medicine and Clinical Immunology, University Hospital of Dijon, University of Burgundy, Dijon, France.

出版信息

Scand J Rheumatol. 2019 Nov;48(6):474-481. doi: 10.1080/03009742.2019.1661011.

DOI:10.1080/03009742.2019.1661011
PMID:31766965
Abstract

: To compare the clinical presentation and outcome of giant cell arteritis (GCA)-related aortitis according to the results of temporal artery biopsy (TAB).: Patients with GCA-related aortitis diagnosed between 2000 and 2017, who underwent TAB, were retrospectively included from a French multicentre database. They all met at least three American College of Rheumatology criteria for the diagnosis of GCA. Aortitis was defined by aortic wall thickening > 2 mm on computed tomography scan and/or an aortic aneurysm, associated with an inflammatory syndrome. Patients were divided into two groups [positive and negative TAB (TAB+, TAB-)], which were compared regarding aortic imaging characteristics and aortic events, at aortitis diagnosis and during follow-up.: We included 56 patients with TAB+ (70%) and 24 with TAB- (30%). At aortitis diagnosis, patients with TAB- were significantly younger than those with TAB+ (67.7 ± 9 vs 72.3 ± 7 years, p = 0.022). Initial clinical signs of GCA, inflammatory parameters, and glucocorticoid therapy were similar in both groups. Coronary artery disease and/or lower limb peripheral arterial disease was more frequent in TAB- patients (25% vs 5.3%, p = 0.018). Aortic wall thickness and type of aortic involvement were not significantly different between groups. Diffuse arterial involvement from the aortic arch was more frequent in TAB- patients (29.1 vs 8.9%, p = 0.03). There were no differences between the groups regarding overall, aneurism-free, relapse-free, and aortic event-free survival.: Among patients with GCA-related aortitis, those with TAB- are characterized by younger age and increased frequency of diffuse arterial involvement from the aortic arch compared to those with TAB+, without significant differences in terms of prognosis.

摘要

: 比较根据颞动脉活检(TAB)结果的巨细胞动脉炎(GCA)相关大动脉炎的临床表现和结局:从法国多中心数据库中回顾性纳入 2000 年至 2017 年间诊断为 GCA 相关大动脉炎且接受 TAB 的患者。所有患者均符合美国风湿病学会(ACR)诊断 GCA 的至少三项标准。通过计算机断层扫描(CT)扫描和/或主动脉瘤确定主动脉壁增厚>2mm 定义为大动脉炎,伴有炎症综合征。将患者分为两组[TAB+(TAB+,TAB-)],比较两组的主动脉影像学特征和主动脉事件,在大动脉炎诊断时和随访期间。:我们纳入了 56 例 TAB+(70%)和 24 例 TAB-(30%)患者。在大动脉炎诊断时,TAB-患者明显比 TAB+患者年轻(67.7±9 岁比 72.3±7 岁,p=0.022)。两组的初始 GCA 临床症状、炎症参数和糖皮质激素治疗相似。TAB-患者的冠状动脉疾病和/或下肢外周动脉疾病更为常见(25%比 5.3%,p=0.018)。两组之间主动脉壁厚度和主动脉受累类型无显著差异。TAB-患者弥漫性主动脉弓受累更为常见(29.1%比 8.9%,p=0.03)。两组在总体生存率、无瘤生存率、无复发生存率和无主动脉事件生存率方面无差异。:在 GCA 相关大动脉炎患者中,与 TAB+患者相比,TAB-患者的特点是年龄较小,主动脉弓弥漫性受累的频率较高,但在预后方面无显著差异。

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