この患者さんは動脈炎ですか?
Gerald W Smetana1, Robert H Shmerling
1Beth Israel Deaconess Medical Center, 330 Brookline Ave, Boston, MA 02215, USA.
JAMA
|January 12, 2002
まとめ
視力喪失を防ぐには,一時性動脈炎 (TA) の診断が不可欠です. のクラウディケーションと二眼視は,TAの疑いを高め,正常な赤血球沈殿率 (ESR) は,TAの可能性を下げます.
科学分野:
- レウマトロジーの病理学
- 内科内科は,内科の内科である.
- 診断の精度 診断の精度
背景:
- テンポラル動脈炎 (TA) の正確な診断は,不可逆的な視力喪失を防ぐために不可欠です.
- 疑わしいTAにおける特定の徴候および症状の診断的価値は不明である.
研究 の 目的:
- 歴史的特徴,身体検査,およびTAの赤血球沈殿率 (ESR) の診断の正確性を評価するために.
主な方法:
- 英語記事 (1966-2000年) の体系的な文献レビューと文献の検索.
- バイオプシー・ポジティブとバイオプシー・ネガティブの両方の患者を含む21のコア研究を含む41の研究を含む.
- 2人の著者による独立したデータ抽象化と品質評価.
主要な成果:
- のクラジケーション (LR+,4.2) と二眼視 (LR+,3.4) は,紹介された患者でTAの可能性を大幅に増加させた.
- テンポラル動脈のビーディング (LR+,4.6),突起 (LR+,4.3),および繊細さ (LR+,2.6) は,予測的な物理的発見でした.
- 正常なESR値は,TAの確率を大幅に低下させた (異常なESRに対するLR-は0.2).
結論:
- 特定の臨床的特徴は,疑わしいTAの陽性な側頭動脈生検結果を予測するのに役立ちます.
- 正常なESRは最も有用な指標であり,TAの診断を少なくする.
関連する概念動画
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