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主动脉炎:跨学科的挑战

Aortitis - An Interdisciplinary Challenge.

机构信息

First Department of Medicine, University Medical Centre Mannheim, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany.

Vascular Center Oberrhein, Internal Medicine I, Diakonissenkrankenhaus Mannheim, Mannheim, Germany.

出版信息

In Vivo. 2021 Jan-Feb;35(1):41-52. doi: 10.21873/invivo.12230.

Abstract

The term 'aortitis' comprises a heterogeneous spectrum of diseases, with varied etiology and clinical presentations, whose common characteristic is the inflammation of the aortic wall. Since aortitis can mimic almost all common cardiovascular disorders, its clinical recognition remains a challenge. Some cases of aortitis remain undetected for a long time and may be diagnosed after severe life-threatening complications have already arisen. The diagnosis of aortitis is based on the presence of homogeneous circumferential thickening of the aortic wall detected on aortic imaging, or typical histological features in combination with clinical findings and laboratory parameters. Management of aortitis is usually conservative (immunosuppressive drugs in noninfectious aortitis; antimicrobial drugs in infectious). However, if vascular complications such as aortic aneurysm, rupture, or steno-occlusive events appear, aortic surgery or endovascular therapy may be required. This review article summarizes the current knowledge regarding the etiology, clinical presentation, diagnosis, and treatment of inflammatory diseases of the aorta to promote better clinical management of these entities.

摘要

“主动脉炎”一词包含了一系列具有不同病因和临床表现的异质性疾病,其共同特征是主动脉壁的炎症。由于主动脉炎几乎可以模仿所有常见的心血管疾病,因此其临床诊断仍然具有挑战性。一些主动脉炎病例在很长一段时间内都未被发现,并且可能在已经出现严重危及生命的并发症后才被诊断出来。主动脉炎的诊断基于主动脉影像学检查发现的主动脉壁均匀环状增厚,或典型的组织学特征结合临床发现和实验室参数。主动脉炎的治疗通常是保守的(非感染性主动脉炎用免疫抑制剂;感染性主动脉炎用抗菌药物)。但是,如果出现主动脉瘤、破裂或狭窄-闭塞性事件等血管并发症,则可能需要主动脉手术或血管内治疗。本文综述了目前关于主动脉炎症性疾病的病因、临床表现、诊断和治疗的知识,以促进对这些疾病的更好的临床管理。

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