治疗头两个月后风湿性多肌痛/巨细胞动脉炎的临床及实验室病程
The clinical and laboratory course of polymyalgia rheumatica/giant cell arteritis after the first two months of treatment.
作者信息
Kyle V, Hazleman B L
机构信息
Rheumatology Research Unit, Addenbrooke's Hospital, Cambridge, United Kingdom.
出版信息
Ann Rheum Dis. 1993 Dec;52(12):847-50. doi: 10.1136/ard.52.12.847.
OBJECTIVES
To examine the clinical course of polymyalgia rheumatica (PMR) and giant cell arteritis (GCA) in a prospective study, after the initial two months.
METHODS
Seventy four patients with PMR/GCA were followed for a median of 60 weeks. Detailed clinical and laboratory records were made on each visit.
RESULTS
Twenty per cent of patients with PMR developed GCA and 24% of patients with GCA developed PMR from the onset of symptoms. After two months, most patients experienced at least one relapse. Relapses and persistence of abnormal symptoms and signs were most common in patients with both PMR and GCA and least common in those with GCA alone. Relapses were most common in the first year and 54% occurred in association with steroid reduction. Major complications were rare. Laboratory parameters and temporal artery histology were not helpful in predicting relapse. Only 24% of patients were able to stop steroid treatment after two years.
CONCLUSIONS
Clinicians should consider more frequent review in patients at times of steroid reduction and especially within the first six months of treatment.
目的
在一项前瞻性研究中，观察多肌痛（PMR）和巨细胞动脉炎（GCA）在最初两个月后的临床病程。
方法
对74例PMR/GCA患者进行了为期60周的随访。每次就诊时都详细记录了临床和实验室检查结果。
结果
从症状出现开始，20%的PMR患者发展为GCA，24%的GCA患者发展为PMR。两个月后，大多数患者至少经历了一次复发。症状和体征异常的复发及持续在PMR和GCA患者中最为常见，而仅患有GCA的患者中最不常见。复发在第一年最为常见，54%的复发与激素减量有关。主要并发症很少见。实验室参数和颞动脉组织学检查对预测复发没有帮助。两年后只有24%的患者能够停用激素治疗。
结论
临床医生应考虑在激素减量时，尤其是在治疗的前六个月内，对患者进行更频繁的复查。
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