2002~2017年大动脉炎住院患者诊疗趋势  

Diagnostic and treatmen trends in in-patients with Takayasu arteritis from 2002 to 2017

作　　者：杨丽睿 贾淑杰[1] 池喆[1] 周芸[1] 李菁[1] Yang Lirui;Jia Shujie;Chi Zhe;Zhou Yun;Li Jing(Department of Special Medical Service,Beijing Anzhen Hospital,Capital Medical University,Beijing 100029,China;不详)

机构地区：[1]首都医科大学附属北京安贞医院特需医疗科,北京100029

出　　处：《中国循证心血管医学杂志》2020年第11期1370-1373,共4页Chinese Journal of Evidence-Based Cardiovascular Medicine

摘　　要：目的探讨2002~2017年中国北京单中心大动脉炎患者在临床特征、病变特点和诊疗策略的变化趋势。方法查阅北京安贞医院2002年、2007年、2012年和2017年住院的大动脉炎患者,并收集相关病历资料。结果共收集病历资料139份(2002年24份,2007年22份,2012年29份,2017年64份)。自2002~2017年,大动脉患者的中位发病年龄、中位延诊时间无明显变化,女性占比无明显变化。心血管危险因素中血脂异常率和吸烟的比例无明显改变。首诊原因中因高血压就诊的比例无明显变化(P=0.06)。合并症中高血压的比例2002年(60.5%),2007年(59.1%),2012年(62.1%),2017年(87.5%),具有明显差异,且高血压的比例逐渐上升,冠状动脉粥样硬化性心脏病(冠心病)及心力衰竭比例无明显差异。临床症状上间歇性肢体运动乏力有明显差异(P=0.04)。大动脉炎活动性无明显差异(P=0.07)。病变性质上狭窄-闭塞型病变及狭窄-扩张型病变有明显差异(P=0.0003,P=0.004)。受累部位方面,升主动脉、腹主动脉、肠系膜上动脉、左肾动脉和右肾动脉受累上均有明显差异。治疗方面,激素、降压药和降脂药的应用有明显差异,且用药率呈逐渐上升趋势。结论2002~2017年间,该中心大动脉炎患者高血压患病率逐渐上升,胸降主动脉受累下降而腹主动脉及其分支受累明显增多,激素、降压药和降脂药的应用迅速增长。Objective To investigate the change trends of clinical characteristics,pathologic features and Diagnostic and treatment strategies in patients with Takayasu arteritis in Beijing in China from 2002 to 2017.Methods The patients with Takayasu arteritis hospitalized in Beijing Anzhen Hospital were consulted in 2002,2007,2012 and 2017,and their medical history data was collected.Results There were totally 139 case documents collected(24 in 2002,22 in 2007,29 in 2012 and 64 in 2017).From 2002 to 2017,the median onset age,median delay time and female percentage in patients with Takayasu arteritis had no significantly changes,among cardiovascular risk factors,dyslipidemia and smoking percentage had no significantly changes,and among firstvisit reasons,hypertension percentage had no significantly changes(P=0.06).In complications,the proportions of hypertension was 60.5%in 2002,59.1%in 2007,62.1%in 2012 and 87.5%in 2017 with significant difference,and proportion of hypertension increased year by year and proportions of coronary heart disease and heart failure had no significant difference.In clinical symptoms,intermittent claudication had significant difference(P=0.04),activities of Takayasu arteritis had no significant difference(P=0.07),and in lesions nature,stenosis-occlusion lesions and stenosis-ectasia had significant difference(P=0.0003,P=0.004).In involved vessels,ascending aorta,abdominal aorta,superior mesenteric artery,left renal artery and right renal artery had significant difference.As to treatment,the administrations of hormones,antihypertensive drugs and lipid-lowering drugs had significant difference,and drug administration rate showed an increase trends gradually.Conclusion The prevalence of hypertension increased gradually,involved descending aorta decreased,involved abdominal aorta and its branches increased significantly,and administrations of hormones,antihypertensive drugs and lipid-lowering drugs increased rapidly in patients with Takayasu arteritis from 2002 to 2017.

关 键 词：大动脉炎 临床特点 治疗 

分 类 号：R543.11[医药卫生—心血管疾病]