566例大动脉炎患者的临床特点及预后  

Clinical Manifestation and Long-term Outcome in 566 Patients With Takayasu's Arteritis

作　　者：杨丽睿[1] 张慧敏[1] 蒋雄京[1] 邹玉宝[1] 秦芳[1] 宋雷[1] 关婷[1] 吴海英[1] 周宪梁[1] 卞瑾[1] 惠汝太 郑德裕[1] 

机构地区：[1]北京协和医学院中国医学科学院国家心血管病中心阜外心血管病医院高血压诊治中心,北京市100037

出　　处：《中国循环杂志》2015年第9期849-853,共5页Chinese Circulation Journal

摘　　要：目的:探讨中国单中心566例大动脉炎患者的临床特点及预后情况。方法:回顾性分析2002-01至2013-11在我院住院的566例大动脉炎患者的临床特点、实验室检查、影像学检查、治疗策略及预后情况。结果:男女比例为1:3.8,平均发病年龄为(28.9±12.0)岁。最常见的非特异性症状、初始症状及并发症分别为发热52例(9.2%)、头晕214例(37.8%)和高血压392例(69.3%)。肺动脉和冠状动脉受累的患者分别有83例(14.7%)和66例(11.7%)。131例(23.1%)患者血沉增快。血管受累的性质以狭窄—闭塞性病变为主,最常见受累血管为左锁骨下动脉,共278例(49.1%)。治疗措施包括药物治疗、介入治疗、自体血管移植术、人工血管置换术及主动脉瓣置换术等。经过平均(5.0±0.2)年的随访,共32例患者死亡。高血压、主要并发症和疾病进展是影响大动脉炎患者预后的主要因素(回归系数分别为4.664、1.959和1.870,P均<0.05)。结论:高血压是中国大动脉炎患者就诊的首要原因。高血压、主要并发症和疾病进展是影响大动脉炎患者预后的主要因素。由于大动脉炎与心血管事件密切相关,早期诊断和治疗至关重要。Objective： To explore a single center large cohort of patients with Takayasu＇s arteritis for their clinical manifestation and long-term outcome in China. Methods： We retrospectively analyzed 566 patients with Takayasu＇s arteritis admitted in our hospital from 2002-0l to 2013-11 for their clinical characteristics, laboratory findings, angiographic features, treatment and long-term outcomes. Results： The patient＇s ratio for female to male gender was 1 to 3.8 and the average onset age was （28.9 ± 12.0） years. The most common non-specific symptom, initial symptom and complication were fever （52/566 patients, 9.2%）, dizziness （214 patients, 37.8%） and hypertension （392 patients, 69.3%） respectively. The patients with pulmonary artery and coronary artery involvement were 83 （14.7%） and 66 （11.7%） respectively, and 131 （23.1%） patients had faster erythrocyte sedimentation rate. The major vascular damage was steno-occlusive lesion and the most common involvement was left sub-clavian artery, which was observed in 278 （49.1%） patients. The treatments were mainly included in medication, interventional therapy, autologous blood vessel transplantation, artificial blood vessel transplantation and aortic valve replacement. There were 32 patients died during the mean follow-up period of（5.0 ± 0.2） years. Hypertension, complication and the progressive stage of disease were the major factors affecting prognosis in relevant patients （regression coefficients： 4.664, 1.959 and 1.870 respectively, all P〈0.05）. Conclusion： Hypertension was the leading reason for patients＇ hospital visit. Takayasu＇s arteritis was closely related tocardiovascular disease, the early diagnosis and treatment were really important in clinical practice.

关 键 词：大动脉炎 临床特点 预后 

分 类 号：R54[医药卫生—心血管疾病]