Le Tourneau T, Agraou B, Beregi J P, Maurage C A, Asseman E P
Service de cardiologie, hôpital de Cambrai.
Arch Mal Coeur Vaiss. 1997 Oct;90(10):1403-7.
Horton's disease is a giant cell arteritis well known for its presentation as temporal arteritis. It is, in fact, a systemic disease which affects over 1% of the general populations after 50 years of age. With the exception of the risk of blindness by occlusion of the ophthalmic artery, the cardiovascular manifestations of Horton's disease are not well known and probably underestimated by clinicians. The main complications are involvement of the large arteries, especially the thoracic aorta and subclavian and axillary arteries, the femoro-popliteal axis and supra-aortic arterial vessels. During the initial phase of the disease, extension of arteritis to the carotid and vertebral arteries is of particular concern because of the risk of cerebral infarction. The coronary arteries, myocardium, pericardium of pulmonary arteries may also be affected by the inflammatory process. In the long-term, Horton's disease may be complicated by aneurysms, dissection of parietal rupture of the thoracic aorta. Treatment is based on steroid therapy, sometimes associated with antiplatelet agents or anticoagulants during the initial phase of treatment. Long-term follow-up is justified because of the risk of late aortic complications.
霍顿病是一种以颞动脉炎形式表现而闻名的巨细胞动脉炎。实际上，它是一种系统性疾病，在50岁以上的普通人群中发病率超过1%。除了因眼动脉阻塞导致失明的风险外，霍顿病的心血管表现并不为人熟知，临床医生可能对此估计不足。主要并发症是大动脉受累，尤其是胸主动脉、锁骨下动脉和腋动脉、股腘动脉轴以及主动脉弓上动脉血管。在疾病的初始阶段，由于存在脑梗死风险，动脉炎扩展至颈动脉和椎动脉尤其值得关注。冠状动脉、心肌、肺动脉的心包也可能受到炎症过程的影响。从长远来看，霍顿病可能会并发动脉瘤、胸主动脉壁间破裂或夹层。治疗基于类固醇疗法，在治疗初始阶段有时会联合使用抗血小板药物或抗凝剂。由于存在晚期主动脉并发症的风险，进行长期随访是合理的。
