巨细胞动脉炎中的血管炎分布和临床特征:使用新的2022 ACR/EULAR分类标准进行了回顾性研究
Peter M Andel1,2,3, Andreas P Diamantopoulos4, Geirmund Myklebust5
1Division of Rheumatology, Department of Rheumatology, Surgery, Inflammation and Transplantation, Oslo University Hospital Rikshospitalet, Oslo, Norway.
Frontiers in medicine
|November 29, 2023
概括
2022年ACR/EULAR标准比旧标准更好地识别巨细胞动脉炎 (GCA) 患者. 混合GCA是最常见的表型,具有与骨或大血管参与相关的明显症状.
科学领域:
- 类风湿病学 类风湿病学
- 血管医学 血管医学
- 诊断成像 诊断成像 诊断成像
背景情况:
- 巨细胞关节炎 (GCA) 是老年人最常见的血管炎.
- 先进的成像模式越来越多地用于GCA诊断,补充或取代动脉活检 (TAB).
- GCA呈现出不同的表型:头骨GCA (c-GCA),大血管GCA (LV-GCA) 和混合GCA.
研究的目的:
- 评估2022年美国风湿病学会 (ACR) /欧洲反风湿病联盟 (EULAR) GCA诊断分类标准的实用性.
- 用新的标准和EULAR核心数据集分析血管炎分布和患者特征.
- 将2022年ACR/EULAR标准的诊断性能与1990年ACR标准进行比较.
主要方法:
- 在2006-2019年间在单中心快速诊所 (FTC) 诊断的GCA患者的回顾性队列研究.
- 在所有被纳入患者的诊断时,对头骨和非头骨大血管进行了超声波 (US).
- 患者使用EULAR核心数据集,1990年ACR标准和2022年ACR/EULAR标准进行了表征.
主要成果:
- 在77名GCA患者中,71人 (92.2%) 接受了美国的协助诊断.
- 2022年ACR/EULAR标准将69名患者 (97.2%) 分类为GCA,而1990年ACR标准将49名患者 (69.0%) 分类为GCA.
- 混合GCA是最常见的表型 (46.5%). 体重减轻与LV-GCA和混合GCA有关,而头痛表明部受影响.
结论:
- 混合GCA是这个队列中占主导地位的亚型.
- 与1990年ACR标准相比,2022年ACR/EULAR分类标准在诊断美国FTC管理的GCA患者方面具有更高的实用性.
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