国际免疫学杂志
國際免疫學雜誌
국제면역학잡지
INTERNATIONAL JOURNAL OF IMMUNOLOGY
2013年
1期
75-78
,共4页
王梅英%邹世海%傅碧玲%彭鑫
王梅英%鄒世海%傅碧玲%彭鑫
왕매영%추세해%부벽령%팽흠
巨细胞动脉炎%活检%预后
巨細胞動脈炎%活檢%預後
거세포동맥염%활검%예후
Giant cell arteritis%Biopsy%Prognosis
目的 分析巨细胞动脉炎(GCA)临床病理资料,为该病的诊断、治疗及判断预后提供依据.方法 回顾性分析36例GCA患者的病理资料和随访结果.结果 确诊的36例GCA患者中,临床表现以头痛最多,其次是颞动脉搏动异常和发热,分别占72.2％、61.1％和47.2％,颞动脉活检阳性率80.6％,其中活动性病变19例(52.8％),慢性病变10例(27.8％),活检阴性7例(19.4％).所有病例给予激素治疗,部分加用免疫抑制剂.全部病例均获得随访资料.经H检验,3组间差异有统计学意义(H=6.132,P=0.037)；两两比较发现,活动组的好转和治愈百分比(78.9％)高于慢性组(60％),低于活检阴性组(85.7％).活动组激素治疗效果好,与活检阴性组比较,差异无统计学意(H=9.879,P =0.057).结论 头痛特别是伴有颞动脉搏动异常的头痛是GCA患者的主要症状,激素及免疫抑制剂是目前GCA的首选治疗措施,临床诊断与颞动脉活检病理相结合是诊断GCA的金标准,病理类型是影响预后的重要因素.
目的 分析巨細胞動脈炎(GCA)臨床病理資料,為該病的診斷、治療及判斷預後提供依據.方法 迴顧性分析36例GCA患者的病理資料和隨訪結果.結果 確診的36例GCA患者中,臨床錶現以頭痛最多,其次是顳動脈搏動異常和髮熱,分彆佔72.2％、61.1％和47.2％,顳動脈活檢暘性率80.6％,其中活動性病變19例(52.8％),慢性病變10例(27.8％),活檢陰性7例(19.4％).所有病例給予激素治療,部分加用免疫抑製劑.全部病例均穫得隨訪資料.經H檢驗,3組間差異有統計學意義(H=6.132,P=0.037)；兩兩比較髮現,活動組的好轉和治愈百分比(78.9％)高于慢性組(60％),低于活檢陰性組(85.7％).活動組激素治療效果好,與活檢陰性組比較,差異無統計學意(H=9.879,P =0.057).結論 頭痛特彆是伴有顳動脈搏動異常的頭痛是GCA患者的主要癥狀,激素及免疫抑製劑是目前GCA的首選治療措施,臨床診斷與顳動脈活檢病理相結閤是診斷GCA的金標準,病理類型是影響預後的重要因素.
목적 분석거세포동맥염(GCA)림상병리자료,위해병적진단、치료급판단예후제공의거.방법 회고성분석36례GCA환자적병리자료화수방결과.결과 학진적36례GCA환자중,림상표현이두통최다,기차시섭동맥박동이상화발열,분별점72.2％、61.1％화47.2％,섭동맥활검양성솔80.6％,기중활동성병변19례(52.8％),만성병변10례(27.8％),활검음성7례(19.4％).소유병례급여격소치료,부분가용면역억제제.전부병례균획득수방자료.경H검험,3조간차이유통계학의의(H=6.132,P=0.037)；량량비교발현,활동조적호전화치유백분비(78.9％)고우만성조(60％),저우활검음성조(85.7％).활동조격소치료효과호,여활검음성조비교,차이무통계학의(H=9.879,P =0.057).결론 두통특별시반유섭동맥박동이상적두통시GCA환자적주요증상,격소급면역억제제시목전GCA적수선치료조시,림상진단여섭동맥활검병리상결합시진단GCA적금표준,병리류형시영향예후적중요인소.
Objective To study the clinical pathology of Giant cell arteritis and analyze the factors of prognosis.Methods 36 cases of Giant cell arteritis were studied retrospectively.Results The clinical presentations included headache (72.2％),abnormal pulsation of temporal artery (61.1％) and fever(47.2％).The positive rate of temporal artery biopsy was 80.6％,including 19 active cases (52.8％),10 chronic cases (27.8％) and 7 biopsy negative cases(19.4％).All patients were treated with hormone therapy,part of cases were added with immunosuppressive agents.All patients were followed up for information.The improvement and cure percents of three groups were tested by H check,and the difference was evidently significant (H =6.132,P =0.037).When those were compared between each group by U test,we found the cure percents in active cases group were higher than that in chronic cases,but lower than that in biopsy negative cases group.The effect of hormone treatment was good in active cases group,and there was not a significant difference (H =9.879,P =0.057,P ＞ 0.05)in comparison with biopsy negative cases group.Conclusion Headache is the major clinical presentations of Giant cell arteritis,especially accompanied by abnormal pulsation of temporal artery.Hormone is the main treatment of Giant cell arteritis and immunosuppressive agents must be adequately used.The combination of clinical diagnosis and temporal artery biopsy may be a gold standard in diagnosis of GCA.The prognosis is related to pathological types of temporal artery.
