非感染性大动脉炎的谱和结局。

Spectrum and Outcome of Noninfectious Aortitis.

机构信息

Y. Ferfar, MD, M. Vautier, MD, C. Comarmond, MD, PhD, A.C. Desbois, MD, PhD, F. Domont, MD, P. Cacoub, MD, D. Saadoun, MD, PhD, Sorbonne Universités, Department of Internal Medicine and Clinical Immunology, Centre de Référence des Maladies Auto-Immunes Systémiques Rares, Centre de Référence des Maladies Auto-Inflammatoires et de l'Amylose inflammatoire, Paris.

S. Morinet, MD, M. Resche-Rigon, MD, PhD, L. Biard, MD, PhD, AP-HP Department of Biostatistics and Medical Information, Hôpital Saint-Louis; ECSTRRA Team, CRESS UMR 1153, INSERM, University of Paris, Paris.

出版信息

J Rheumatol. 2021 Oct;48(10):1583-1588. doi: 10.3899/jrheum.201274. Epub 2021 Jul 1.

DOI:10.3899/jrheum.201274

PMID:34210830

Abstract

OBJECTIVE

To assess the spectrum and long-term outcome of patients with noninfectious aortitis.

METHODS

We performed a retrospective multicenter study of 353 patients (median age at diagnosis was 62 [IQR 46-71] yrs and 242 [68.6%] patients were women) with noninfectious aortitis. Factors associated with vascular complications were assessed in multivariate analysis.

RESULTS

We included 136 patients with giant cell arteritis (GCA), 96 with Takayasu arteritis (TA), 73 with clinically isolated aortitis (CIA), and 48 with aortitis secondary to inflammatory diseases (including Behçet disease, relapsing polychondritis, IgG4-related disease, Cogan syndrome, ankylosing spondylitis). After a median follow-up of 52 months, vascular complications were observed in 32.3%, revascularizations in 30% of patients, and death in 7.6%. The 5-year cumulative incidence of vascular complications was 58% (95% CI 41-71), 20% (95% CI 13-29), and 19% (95% CI 11-28) in CIA, GCA, and TA, respectively. In multivariate analysis, male sex (HR 2.10, 95% CI 1.45-3.05, < 0.0001) and CIA (HR 1.76, 95% CI 1.11-2.81, = 0.02) were independently associated with vascular complications.

CONCLUSION

Noninfectious aortitis accounts for significant morbidity and mortality. CIA seems to carry the highest rate of vascular complications.

摘要

目的

评估非感染性大动脉炎患者的发病谱和长期预后。

方法

我们进行了一项回顾性多中心研究，共纳入 353 名非感染性大动脉炎患者（中位诊断年龄为 62 岁[四分位距 46-71]岁，242 名[68.6%]患者为女性）。多因素分析评估了与血管并发症相关的因素。

结果

我们纳入了 136 名巨细胞动脉炎（GCA）患者、96 名 Takayasu 动脉炎（TA）患者、73 名孤立性主动脉炎（CIA）患者和 48 名炎症性疾病相关的主动脉炎患者（包括贝赫切特病、复发性多软骨炎、IgG4 相关疾病、Cogan 综合征、强直性脊柱炎）。中位随访 52 个月后，32.3%的患者发生血管并发症，30%的患者进行了血运重建，7.6%的患者死亡。CIA、GCA 和 TA 患者的 5 年血管并发症累积发生率分别为 58%（95%CI 41-71）、20%（95%CI 13-29）和 19%（95%CI 11-28）。多因素分析显示，男性（HR 2.10，95%CI 1.45-3.05， < 0.0001）和 CIA（HR 1.76，95%CI 1.11-2.81， = 0.02）是血管并发症的独立危险因素。