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Takayasu 动脉炎的诊断和治疗进展。

Updates in the diagnosis and management of Takayasu's arteritis.

机构信息

Division of Rheumatology, Thomas Jefferson University Hospital, Philadelphia, USA.

出版信息

Postgrad Med. 2023 Jan;135(sup1):14-21. doi: 10.1080/00325481.2022.2159723. Epub 2023 Jan 2.

Abstract

Takayasu's arteritis is a rare, chronic, large vessel vasculitis which affects the aorta and its large branches. Early diagnosis is important to prevent serious end organ damage, including to stroke and ischemic heart disease. Studies have demonstrated treatment response with methotrexate, azathioprine, and tumor necrosis factor (TNF) inhibitors. This article aims to describe to the reader key features of Takayasu's arteritis and highlights updated evidence in the diagnosis and management of these patients. We also review the 2021 ACR guidelines for Takayasu's arteritis and correlate them to the updated evidence discussed throughout the review. An extensive literature search was conducted via PUBMED, including the words 'Takayasu's diagnostic criteria,' 'Takayasu's treatment,' 'Takayasu's diagnosis,' 'Takayasu's imaging', and 'Takayasu's diagnostic criteria.' Search was filtered to include clinical trials, randomized controlled trials, systematic reviews, and meta-analyses. Articles in the English language or with English translation and published by the date of 20 December 2021 were included.

摘要

Takayasu 动脉炎是一种罕见的、慢性的、累及大动脉的大血管炎,可影响主动脉及其大分支。早期诊断对于预防严重的终末器官损害至关重要,包括中风和缺血性心脏病。研究表明,甲氨蝶呤、硫唑嘌呤和肿瘤坏死因子(TNF)抑制剂可有效治疗该病。本文旨在向读者介绍 Takayasu 动脉炎的主要特征,并重点阐述该病在诊断和治疗方面的最新进展。我们还回顾了 2021 年 ACR Takayasu 动脉炎指南,并将其与本文中讨论的最新证据进行了关联。我们通过 PUBMED 进行了广泛的文献检索,检索词包括“Takayasu 诊断标准”、“Takayasu 治疗”、“Takayasu 诊断”、“Takayasu 影像学”和“Takayasu 诊断标准”。检索结果限定为临床试验、随机对照试验、系统评价和荟萃分析,并限定为 2021 年 12 月 20 日之前发表的英文或有英文翻译的文章。

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