Huston K A, Hunder G G
Am Heart J. 1980 Jul;100(1):99-105. doi: 10.1016/0002-8703(80)90285-9.
Giant cell arteritis is a disease of the elderly which is more common than previously recognized. It is important to be aware of this condition because treatment effectively relieves symptoms and prevents serious complications. The disease is suggested when an elderly patient complains of constitutional symptoms, headache, jaw claudication, or the musculoskeletal manifestations of polymyalgia rheumatica. Abnormalities in temporal arteries or other cranial arteries, or evidence of large vessel involvement may be detected by physical examination. A markedly elevated sedimentation rate in association with other clinical features of the disease strongly suggests giant cell arteritis, but a biopsy should be performed to confirm the diagnosis. Corticosteroid therapy should be started promptly in high doses in order to prevent blindness. Prolonged treatment with lower dose corticosteroids is generally necessary for up to 1 to 2 years, and sometimes longer, for continued symptomatic relief. Long-term follow-up of treated patients has demonstrated no detectable effect on survivorship.
巨细胞动脉炎是一种多见于老年人的疾病，其发病率比以往认为的更高。了解这种疾病很重要，因为治疗可有效缓解症状并预防严重并发症。当老年患者主诉有全身症状、头痛、颌部间歇性运动障碍或风湿性多肌痛的肌肉骨骼表现时，应考虑该病。体格检查可能发现颞动脉或其他颅动脉异常，或大血管受累的证据。血沉显著升高并伴有该病的其他临床特征强烈提示巨细胞动脉炎，但应进行活检以确诊。应立即开始大剂量皮质类固醇治疗以预防失明。通常需要用较低剂量的皮质类固醇进行长达1至2年，有时更长时间的持续治疗，以持续缓解症状。对接受治疗的患者进行长期随访表明，对生存率没有可检测到的影响。
