Dos Santos A M, Misse R G, Borges I B P, Pereira R M R, Shinjo S K
Division of Rheumatology, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, SP.
Reumatismo. 2021 Jan 18;72(4):197-206. doi: 10.4081/reumatismo.2020.1298.
Limb vascular claudication and hand muscle weakness are common symptoms of Takayasu arteritis (TAK). However, no studies have correlated these two symptoms. Therefore, the aim of the study was to evaluate handgrip strength and its correlation with both upper-limb vascular claudication and imaging of the vessels. This cross-sectional study compared 36 patients with TAK who were matched by age, gender, and body mass index with 36 individuals without TAK (CTR). Hand strength (assessed with handgrip dynamometer), functional capacity (Health Assessment Questionnaire, HAQ), upper-limb vascular claudication symptoms (patients' selfreported form), and disease activity (Indian Takayasu Clinical Activity Score [ITAS] 2010; Physician Global Assessment [PGA], C-reactive protein, and erythrocyte sedimentation rate) were evaluated as well as vessel imaging (e.g., angiotomography or angioresonance) and blood pressure. The median age of the patients was 42.0 years (35.5-51.5 years), whereas the mean disease duration was 13.1±6.8 years. No patient had active disease. Compared to the CTR, the patients with TAK showed reduced strength in the left-hand (22.9±5.9 vs 26.3±5.6 kg; p=0.014) and increased HAQ scores [0.50 (0.12-0.87) vs 0.00 (0.00-0.00); p<0.001]. Both groups had comparable blood pressure. Among patients with TAK, lefthand strength was inversely correlated with HAQ (Spearman correlation: rho=-0.584; p<0.001) and positively correlated with right-hand strength (rho=0.644; p<0.001). Moreover, neither hand's strengths in the patients were correlated with subclavian stenosis imaging, blood pressure or limb vascular claudication. The reduction of strength in the upper left limb is inversely related to the functional capacity (HAQ score) of TAK. This reduction appears unrelated to classical vascular claudication, vessel imaging or blood pressure.
肢体血管间歇性跛行和手部肌肉无力是大动脉炎（TAK）的常见症状。然而，尚无研究将这两种症状联系起来。因此，本研究的目的是评估握力及其与上肢血管间歇性跛行和血管成像的相关性。这项横断面研究将36例年龄、性别和体重指数相匹配的TAK患者与36例非TAK个体（对照组）进行了比较。评估了握力（用握力计测量）、功能能力（健康评估问卷，HAQ）、上肢血管间歇性跛行症状（患者自我报告表）和疾病活动度（2010年印度大动脉炎临床活动评分[ITAS]；医生整体评估[PGA]、C反应蛋白和红细胞沉降率），以及血管成像（如血管断层造影或血管磁共振成像）和血压。患者的中位年龄为42.0岁（35.5 - 51.5岁），平均病程为13.1±6.8年。没有患者处于疾病活动期。与对照组相比，TAK患者左手力量降低（22.9±5.9 vs 26.3±5.6 kg；p = 0.014），HAQ评分升高[0.50（0.12 - 0.87）vs 0.00（0.00 - 0.00）；p < 0.001]。两组血压相当。在TAK患者中，左手力量与HAQ呈负相关（斯皮尔曼相关性：rho = -0.584；p < 0.001），与右手力量呈正相关（rho = 0.644；p < 0.001）。此外，患者双手的力量均与锁骨下狭窄成像、血压或肢体血管间歇性跛行无关。左上肢体力量的降低与TAK的功能能力（HAQ评分）呈负相关。这种降低似乎与经典的血管间歇性跛行、血管成像或血压无关。
