CAJ | 학술논문

目的探讨大动脉炎临床症状、受累血管分布特征及治疗转归。方法回顾性分析173例大动脉炎患者的临床症状、血管影像学、炎性指标及治疗随诊情况。采用f检验进行统计学分析。结果 173例患者中女性136例，男性37例，中位发病年龄23岁。81例(46.6％)患者起病有高血压，72例(41.1％)患者无脉症/脉搏不对称，50例(28.7％)患者有发热的症状；受累血管分布情况：主动脉112例(64.7％)，肺动脉17例(9.8％)，无名动脉33例(19.1％)，颈总动脉114例(65.9％)，锁骨下动脉113例(65.3％)，肾动脉63例(36.2％)，椎动脉21例(12.1％)，腹腔干10例(5.8％)。105例(61.0％)患者红细胞沉降率( ESR)升高。合并活动性/既往结核者45例，占26.0％，乙型肝炎病毒携带者10例，占5.8％。其中105例患者接受随诊，98例(94.2％)在治疗后病情平稳,17例在激素减量过程中病情反复。结论糖皮质激素及（或）免疫抑制剂以及血管严重狭窄或闭塞者适时联合介入与手术，可有效控制大动脉炎患者的临床症状及炎性指标，改善患者的生存质量。
목적 탐토대동맥염림상증상、수루혈관분포특정급치료전귀。방법 회고성분석173례대동맥염환자적림상증상、혈관영상학、염성지표급치료수진정황。채용f검험진행통계학분석。결과 173례환자중녀성136례，남성37례，중위발병년령23세。81례(46.6％)환자기병유고혈압，72례(41.1％)환자무맥증/맥박불대칭，50례(28.7％)환자유발열적증상；수루혈관분포정황：주동맥112례(64.7％)，폐동맥17례(9.8％)，무명동맥33례(19.1％)，경총동맥114례(65.9％)，쇄골하동맥113례(65.3％)，신동맥63례(36.2％)，추동맥21례(12.1％)，복강간10례(5.8％)。105례(61.0％)환자홍세포침강솔( ESR)승고。합병활동성/기왕결핵자45례，점26.0％，을형간염병독휴대자10례，점5.8％。기중105례환자접수수진，98례(94.2％)재치료후병정평은,17례재격소감량과정중병정반복。결론 당피질격소급（혹）면역억제제이급혈관엄중협착혹폐새자괄시연합개입여수술，가유효공제대동맥염환자적림상증상급염성지표，개선환자적생존질량。
Objective To study the clinical features, arterial involvement, therapeutic strategies and outcomes of Takayasu arteritis (TA). Methods The clinical symptoms, arterial images, inflammatory parameters and follow-up information of 173 patients with TA were retrospectively studied. Comparisons between groups were performed by t-test. Results There were 136 female and 37 male patients in this study. The mean age at onset was (26±11 ) years. Hypertension, pulse deficit or asymmetrical pulse, and fever were present in 46.6％, 41.1％, 28.7％ of patients, respectively. The distribution of arterial involvement were 64.7％in aorta, 9.8％ in pulmonary artery, 19.1％ in innominate artery, 65.9％ in common carotid arteries, 65.3％in the subclavian artery, 36.2％ in the renal artery, 12.1％ in the vertebral artery, and 5.8％ in coeliac axis.Elevated erythrocyte sedimentation rate (ESR) was found in 61.0％ patients. Active tuberculosis or history of tuberculosis was implicated in 45 patients (26.0％). Ten patients (5.8％) were hepatitis B virus carriers.Among 105 followed-up patients, 98 patients (94.2％) achieved persistent remission, 17 patients relapsed when corticosteroids were tapered. Conclusion Corticosteroids combined with or steroid alone, supplemented with endovascular intervention procedures or surgical bypass procedures when necessary, can effectively control the clinical symptoms and inflammatory parameters and improve the quality of life of patients.