时间动脉活检 时间动脉活检
Jon Golenbiewski1, Susan Burden1, Rachel M Wolfe1
1Wake Forest School of Medicine, 1 Medical Center Boulevard, Winston-Salem, NC, 27157, USA.
Best practice & research. Clinical rheumatology
|June 1, 2023
概括
巨细胞动脉炎 (GCA) 需要及时治疗,以防止视力丧失或中风. 动脉活检 (TAB) 有助于诊断,但葡萄糖皮质激素的副作用需要在老年患者中进行谨慎的管理.
科学领域:
- 类风湿病学 类风湿病学
- 血管外科 血管外科
- 病理学 病理学 病理学
背景情况:
- 巨细胞动脉炎 (GCA) 是一种普遍的血管炎,影响50岁以上的人.
- 延迟诊断和治疗可能导致严重的缺血并发症,包括永久视力丧失和中风.
- 长期,高剂量的葡萄糖皮质激素治疗在这种老年人群中存在重大风险,原因是并发症.
研究的目的:
- 在疑似GCA病例中探索动脉活检 (TAB) 的指示.
- 根据当前的证据,提供关于执行TAB的实际指导.
- 审查手术程序,潜在的并发症和病理发现,包括差异诊断.
主要方法:
- 对基于证据的指导方针和对动脉活检的研究进行文献综述.
- 分析手术技术和与TAB相关的潜在并发症.
- 在GCA和替代诊断中检查常见的组织病理学发现.
主要成果:
- TAB仍然是GCA的关键诊断工具,指导及时和适当的治疗.
- 概述了基于证据的指示和TAB的程序最佳实践.
- 了解病理发现和替代诊断对于准确的患者管理至关重要.
结论:
- 关动脉活检对于诊断巨细胞动脉炎至关重要,能够迅速治疗以预防不可逆转的并发症.
- 仔细考虑患者的并发症和潜在的葡萄糖皮质激素副作用至关重要.
- 本综述为管理疑似GCA的临床医生提供了实际见解.
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