儿童多发性大动脉炎10例临床特点分析  

Clinical analysis of ten patients with Takayasu arteritis in children

作　　者：童桂霞[1] 王兴翠[1] 王雪[1] 仇慧[1] 潘艳艳[1] 张洪霞[1] TONG Guixia;WANG Xingcui;WANG Xue;QIU Hui;PAN Yanyan;ZHANG Hongxia(Department of Renal Rheumatology Immunology,Children's Hospital Affiliated to Shandong University,Shandong Province,Jinan 250022,China)

机构地区：[1]山东大学附属儿童医院(济南市儿童医院)肾脏风湿免疫科,山东济南250022

出　　处：《中国当代医药》2023年第34期67-71,共5页China Modern Medicine

基　　金：山东省济南市卫生健康委科技计划项目(2022-2-151);山东省济南市卫生健康委大数据计划项目(2022-YBD-14)。

摘　　要：目的探讨儿童多发性大动脉炎(TA)的临床特点。方法回顾性分析2020年1月至2022年12月山东大学附属儿童医院肾脏风湿免疫科10例TA患儿的临床资料、实验室检查、治疗及预后。结果10例患儿中男、女各5例,年龄3月龄~12岁。本研究常见临床症状为高血压5例,血管杂音3例,发热6例,关节痛2例,腹痛、呕吐3例,尿蛋白阳性2例,肾功能异常1例。实验室检查中红细胞沉降率增加9例,C反应蛋白升高7例,白细胞计数升高5例。10例患儿接受糖皮质激素和/或免疫抑制剂治疗,5例接受生物制剂治疗。8例好转,2例失访。结论TA缺乏特异性的临床表现,对于反复发热、高血压、高炎症反应及尿蛋白阳性患儿,应考虑TA可能,尽早完善血管造影助诊。TA以糖皮质激素联合免疫抑制剂治疗有效。Objective To investigate the clinical features,treatment response and prognosis in patients with Takayasu arteritis(TA)in children.Methods Retrospective analysis of clinical data,laboratory examinations,treatment,and prognosis of 10 children with TA in the Department of Renal Rheumatology and Immunology of Children's Hospital Affiliated to Shandong University from January 2020 to December 2022.Results There were five boys and five girls in ten patients with Takayasu arteritis.The onset age was from three months to 12 years old.Hypertension was the most common finding on first presentation in 5 cases,followed by vascular accentuated in 3 cases,fever in 6 cases,arthralgia in 2 cases,abdominal pain and vomiting in 3 cases,proteinuria in 2 cases,renal failure in 1 cases.The active indices of inflammation were increased.It showed increased erythrocyte sedimentation rate in 9 case,increased C reactive protein in 7 cases and increased white cell count in 5 cases.Ten patients were treated with steroids and/or immunosuppressant and five patient was treated with biological agent.Two cases were lost to follow-up,and six cases were improved.Conclusion TA in children lacks specific clinical manifestations.For children with recurrent fever,hypertension,high inflammatory reaction and urinary protein positive,the possibility of TA should be considered and angiography should be improved as soon as possible.Glucocorticoid combined with immunosuppressant is effective.

关 键 词：多发性大动脉炎 儿童 临床特点 血管造影 

分 类 号：R72[医药卫生—儿科]