北京医学
北京醫學
북경의학
BEIJING MEDICAL JOURNAL
2010年
2期
111-113
,共3页
黄光%吴小未%赵建功%唐煜%刘兴洲
黃光%吳小未%趙建功%唐煜%劉興洲
황광%오소미%조건공%당욱%류흥주
颞动脉炎%头痛%血沉
顳動脈炎%頭痛%血沉
섭동맥염%두통%혈침
Temporal artoritis%Headache%Erythrocyte sedimentation rate(ESR)
目的 分析巨细胞动脉炎的临床表现、辅助检查结果及对不同治疗的效果和误诊的原因.方法 对8例患者的首发症状、临床表现、局部检查、实验室检查、组织学检查和对不同治疗的效果进行分析.结果 巨细胞动脉炎可以有不同的首发表现形式,但头痛是主要的临床症状(6例).实验室检查:8例血沉均增快,平均86mm/h;5例血红蛋白减低,平均为6.1g/L;4例CRP增高,平均为132mg/L.颞动脉组织学检查是诊断的一种重要手段,3例行颞动脉检查(6条),5条内膜欠光滑、腔内回声不佳;1条未见异常.皮质激素有非常明显的治疗效果.结论 对以头痛为首发症状的中老年人,特别是颞、枕和颈部胀痛和剧痛,伴或不伴发热、眼胀和复视的患者,要行颞动脉触诊检查,注意血红蛋白、ESR和CRP的变化,必要时行颞动脉超声检查,颞动脉分段活检是诊断巨细胞颞动脉炎的金标准,皮质激素是治疗的首选.
目的 分析巨細胞動脈炎的臨床錶現、輔助檢查結果及對不同治療的效果和誤診的原因.方法 對8例患者的首髮癥狀、臨床錶現、跼部檢查、實驗室檢查、組織學檢查和對不同治療的效果進行分析.結果 巨細胞動脈炎可以有不同的首髮錶現形式,但頭痛是主要的臨床癥狀(6例).實驗室檢查:8例血沉均增快,平均86mm/h;5例血紅蛋白減低,平均為6.1g/L;4例CRP增高,平均為132mg/L.顳動脈組織學檢查是診斷的一種重要手段,3例行顳動脈檢查(6條),5條內膜欠光滑、腔內迴聲不佳;1條未見異常.皮質激素有非常明顯的治療效果.結論 對以頭痛為首髮癥狀的中老年人,特彆是顳、枕和頸部脹痛和劇痛,伴或不伴髮熱、眼脹和複視的患者,要行顳動脈觸診檢查,註意血紅蛋白、ESR和CRP的變化,必要時行顳動脈超聲檢查,顳動脈分段活檢是診斷巨細胞顳動脈炎的金標準,皮質激素是治療的首選.
목적 분석거세포동맥염적림상표현、보조검사결과급대불동치료적효과화오진적원인.방법 대8례환자적수발증상、림상표현、국부검사、실험실검사、조직학검사화대불동치료적효과진행분석.결과 거세포동맥염가이유불동적수발표현형식,단두통시주요적림상증상(6례).실험실검사:8례혈침균증쾌,평균86mm/h;5례혈홍단백감저,평균위6.1g/L;4례CRP증고,평균위132mg/L.섭동맥조직학검사시진단적일충중요수단,3례행섭동맥검사(6조),5조내막흠광활、강내회성불가;1조미견이상.피질격소유비상명현적치료효과.결론 대이두통위수발증상적중노년인,특별시섭、침화경부창통화극통,반혹불반발열、안창화복시적환자,요행섭동맥촉진검사,주의혈홍단백、ESR화CRP적변화,필요시행섭동맥초성검사,섭동맥분단활검시진단거세포섭동맥염적금표준,피질격소시치료적수선.
Objective To observe the clinical manifestations,examinations,different responses to treatment in the giant cell arteritis patients and analyze the causes of misdiagnosis.Methods Eight patients on the initial symptom,clinical pictures,local manefestations,blood tests,blood vessel biopsy and treatment response were analyzed.Results Giant cell arteritis could have different manifestations,but headache was the main clinical symptoms.ESR and CRP have increased significantly.The temporal artery histological examination was an important way of diagnosis,but attention should be paid to the effect of false negative.The corticosteroid had a very good effect.Conclusions When the initial symptom is headache,especial in the temporal,occipital area and neck pain in elderly,with or without fever,eye diplopia,patient should be examined by palpation of the temporal arteries and special attention should he paid to Hg,ESR and CRP.If necessary,arteritis temporal artery ultrasonography should be examined.Temporal artery biopsy is the gold standard for the diagnosis of giant cell.Corticosteroids administration is the first choice of treatment.