药物治疗与彩超评估头臂型大动脉炎的单中心经验  

Single-center experience of drug therapy and color Doppler ultrasound evaluation of brachiocephalic Takayasu arteritis

作　　者：单金涛 化召辉[1] 周保宁 吴菁菡 杜世昌 夏磊[1] 薛文豪 罗云鹏 柴一鸣 李震[1] Shan Jintao;Hua Zhaohui;Zhou Baoning;Wu Jinghan;Du Shichang;Xia Lei;Xue Wenhao;Luo Yunpeng;Chai Yiming;Li Zhen(Department of Endovascular Surgery,The First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,Henan,China;Medical Insurance Management Office,The First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,Henan,China)

机构地区：[1]郑州大学第一附属医院腔内血管外科,河南郑州450052 [2]郑州大学第一附属医院医疗保险管理办公室,河南郑州450052

出　　处：《中国血管外科杂志(电子版)》2025年第1期46-49,54,共5页Chinese Journal of Vascular Surgery(Electronic Version)

基　　金：河南省高等学校重点科研项目计划(23A320017)。

摘　　要：目的探讨药物治疗与彩超评估治疗头臂型大动脉炎的临床经验。方法回顾性分析2012年7月至2022年11月郑州大学第一附属医院治疗的244例头臂型大动脉炎患者临床资料,并通过绘制受试者工作特征(receiver operating characteristic,ROC)曲线分析内膜变化诊断动脉炎症活动期的特异性与灵敏度。结果患者随访1~123个月,平均(48.82±38.17)个月,患者均无并发症发生,其中激素联合甲氨蝶呤、单抗的效果最好,使用激素的维持剂量最小,激素的使用时间最短。205例患者症状得到改善,39例药物治疗后缺血症状仍严重而行手术干预。内膜变化对动脉炎症活动期的ROC曲线下面积为0.908,对应的敏感度为88.9%,特异性为83.3%。结论全程基础药物治疗及彩超评估对头臂型大动脉炎患者的治疗有较大的临床意义。Objective To explore the clinical experience of drug therapy and color Doppler ultrasound evaluation in the treatment of brachiocephalic Takayasu arteritis.Methods The clinical data of 244 patients with brachiocephalic Takayasu arteritis treated in the First Affiliated Hospital of Zhengzhou University from July 2012 to November 2022 were analyzed retrospectively.The specificity and sensitivity of intimal changes in diagnosing active arterial inflammation were analyzed by receiver operating characteristic curve.Results The patients were followed-up for 1 to 123 months,with an average of 48.82±38.17 months.No complications occurred.Hormone combined with methotrexate and monoclonal antibody had the best effect,the maintenance dose of hormone was the smallest,and the duration of hormone use was the shortest.Symptoms of 205 patients improved,while 39 patients underwent surgical intervention because of severe ischemic symptoms after drug treatment.The area under curve of intimal changes for active arterial inflammation was 0.908,with a corresponding sensitivity of 88.9%and a specificity of 83.3%.Conclusion The whole course of basic drug treatment and color Doppler ultrasound evaluation have great clinical significance for the treatment of brachiocephalic Takayasu arteritis.

关 键 词：大动脉炎 超声 药物治疗 

分 类 号：R543.5[医药卫生—心血管疾病]