Michel B A, Arend W P, Hunder G G
Clinic of Rheumatology, University Hospital, Zürich, Switzerland.
J Rheumatol. 1996 Jan;23(1):106-11.
To determine whether giant cell (temporal) arteritis (GCA) can be differentiated from Takayasu's arteritis on the basis of clinical findings.
A comparative study contrasting 217 patients with GCA to 63 patients with Takayasu's arteritis was conducted, using the prospectively gathered large multicenter data set of the American College of Rheumatology Vasculitis Criteria Databank. Logistic regression and recursive partitioning were used to assess the capability of a variety of variables to separate these 2 vasculitic disorders.
Age of 40 years at onset of disease was the most discriminatory single variable. Excluding age at onset, ethnic background and a combination of clinical signs indicating upper limb vascular impairment, shoulder stiffness, and tender scalp led to correct classifications of 95% in both GCA and Takayasu's arteritis. Vascular insufficiency of the upper extremities, a key feature of Takayasu's arteritis, was noted in 15% of patients with GCA, although to a lesser degree.
Although similar in many respects, GCA and Takayasu's arteritis were easily definable and separable disorders, even when the typical age barrier of 40 years at onset of disease was excluded. These findings strengthen the concept that they are distinct disease entities.
基于临床发现确定巨细胞（颞）动脉炎（GCA）是否可与大动脉炎相鉴别。
利用美国风湿病学会血管炎标准数据库前瞻性收集的大型多中心数据集，对217例GCA患者和63例大动脉炎患者进行了一项对比研究。采用逻辑回归和递归划分法评估多种变量区分这两种血管炎疾病的能力。
发病年龄40岁是最具鉴别性的单一变量。排除发病年龄后，种族背景以及提示上肢血管损害、肩部僵硬和头皮压痛的临床体征组合，在GCA和大动脉炎中均能实现95%的正确分类。大动脉炎的关键特征——上肢血管功能不全，在15%的GCA患者中也有发现，尽管程度较轻。
尽管GCA和大动脉炎在许多方面相似，但即使排除发病年龄40岁这一典型界限，它们仍是易于定义和区分的疾病。这些发现强化了它们是不同疾病实体的概念。
