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相关实验视频

这个病人有动脉炎吗?

Gerald W Smetana1, Robert H Shmerling

  • 1Beth Israel Deaconess Medical Center, 330 Brookline Ave, Boston, MA 02215, USA.

JAMA
|January 12, 2002
PubMed
概括
此摘要是机器生成的。

诊断时间性动脉炎 (TA) 对于预防视力丧失至关重要. 关闭和双眼增加TA的怀疑,而正常的红细胞沉积率 (ESR) 使TA不太可能发生.

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科学领域:

  • 类风湿病学 类风湿病学
  • 内部医学 内部医学
  • 诊断的准确性 诊断的准确性

背景情况:

  • 准确诊断动脉炎 (TA) 对于预防不可逆转的视力损失至关重要.
  • 怀疑TA的特定迹象和症状的诊断价值仍然不清楚.

研究的目的:

  • 评估历史特征的诊断准确性,体检,以及TA的红细胞沉积率 (ESR).

主要方法:

  • 对英语文章 (1966-2000) 的系统文献综述和文献查询.
  • 包括41项研究,其中包括21项核心研究,包括活检阳性和活检阴性患者.
  • 两个作者独立抽象数据和质量评估.

主要成果:

  • 在转诊患者中,下巴 (LR+,4.2) 和双眼 (LR+,3.4) 显著增加了TA的可能性.
  • 动脉珠度 (LR+,4.6),突出度 (LR+,4.3) 和柔软度 (LR+,2.6) 是预测性的物理发现.
  • 一个正常的ESR值大大降低了TA的可能性 (LR-对于异常的ESR,0.2).

结论:

  • 特定的临床特征有助于预测疑似TA的阳性动脉活检结果.
  • 正常的ESR是最有用的指标,使得TA诊断的可能性降低.