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伊朗大动脉炎的临床特征和长期预后:一项多中心研究。

Clinical characteristics and long-term outcome of Takayasu arteritis in Iran: a multicentre study.

机构信息

Connective Tissue Diseases Research Centre, Tabriz University of Medical Sciences, Tabriz, Iran

Rheumatology Section, Department of Internal Medicine, Urmia University of Medical Sciences, Urmia, Iran

出版信息

Turk J Med Sci. 2020 Jun 23;50(4):713-723. doi: 10.3906/sag-1910-19.

Abstract

BACKGROUND/AIM: This study aimed to evaluate the demographic, clinical, angiographic and prognostic characteristics of Takayasu arteritis (TA) in Iran.

MATERIALS AND METHODS

A total of 75 patients with TA based on the American College of Rheumatology 1990 criteria for TA classification referred to the Rheumatology Centres, were followed-up from 1989 to 2019. Demographic, clinical, angiographic and prognostic characteristics were collected at baseline and last visit.

RESULTS

The mean age was 31.9 ± 9.8 years at the disease onset. Female to male ratio was 14. The median latency in diagnosis was 24 months. Pulse discrepancy in the arms, blood pressure discrepancy in the arms, limb claudication, hypertension and constitutional symptoms were the most common clinical features. The most common angiographic type at the time of diagnosis was Type I (42.7%). The most frequent arterial lesion was stenosis (89.4%). Subclavian, carotid and aortic arteries were the most commonly involved arteries. New lesions developed in 28.6% of patients during the 5.25-year follow-up. Vasculitis-induced chronic damage was observed in all patients. Disease activity decreased and vascular damage remained stable throughout the follow-up period.

CONCLUSIONS

The clinical features and angiographic type of TA in Iran are different from most Asian countries. Differences in angiographic and clinical features may lead to delayed diagnosis. The issue of delay in diagnosis should create awareness among health care providers that TA is not a very rare disease in Iranians and failure to pay attention to warning symptoms may delay the diagnosis.

摘要

背景/目的:本研究旨在评估伊朗 Takayasu 动脉炎(TA)的人口统计学、临床、血管造影和预后特征。

材料和方法

根据美国风湿病学会 1990 年 TA 分类标准,对 1989 年至 2019 年期间到风湿病中心就诊的 75 例 TA 患者进行了随访。收集了基线和最后一次就诊时的人口统计学、临床、血管造影和预后特征。

结果

疾病发病时的平均年龄为 31.9 ± 9.8 岁。女性与男性的比例为 14。中位诊断延迟时间为 24 个月。手臂脉搏差异、手臂血压差异、肢体跛行、高血压和全身症状是最常见的临床特征。诊断时最常见的血管造影类型是 I 型(42.7%)。最常见的动脉病变是狭窄(89.4%)。锁骨下动脉、颈动脉和主动脉是最常受累的动脉。在 5.25 年的随访中,28.6%的患者出现新病变。所有患者均观察到血管炎引起的慢性损伤。在整个随访期间,疾病活动度降低,血管损伤保持稳定。

结论

伊朗的 TA 临床特征和血管造影类型与大多数亚洲国家不同。血管造影和临床特征的差异可能导致诊断延迟。诊断延迟的问题应引起医疗保健提供者的注意,即 TA 在伊朗并非非常罕见的疾病,如果不注意警告症状,可能会导致诊断延迟。

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