大动脉扩张在巨细胞动脉炎的演变和结果
Sophie Gallou1, Christian Agard2, Anael Dumont3
1Department of Internal Medicine, Caen University Hospital, Caen, France; University of Caen Normandie, Caen, France.
European journal of internal medicine
|April 5, 2024
概括
巨细胞动脉炎 (GCA) 可以导致大动脉扩张. 大动脉炎症和动脉瘤性疾病可能会加速这种进展,影响GCA患者的治疗策略.
科学领域:
- 心血管医学 心血管医学
- 类风湿病学 类风湿病学
- 血管生物学 血管生物学
背景情况:
- 巨细胞动脉炎 (GCA) 是一种全身性血管炎,可以影响大动脉,包括大动脉.
- 大动脉扩张是已知的GCA并发症,但影响其进展的因素仍然不完全理解.
研究的目的:
- 确定与GCA患者大动脉扩张进展率相关的临床和病理因素.
- 在GCA中区分快速进展,缓慢进展和非进展的大动脉扩张.
主要方法:
- 通过纵向成像评估的47名有大动脉扩张的GCA患者的回顾性分析.
- 主动脉扩张进展的分类是快速进展 (FP),缓慢进展 (SP) 和非进展 (NP) 基于随时间变化的直径.
- 在进展组之间比较基线特征,危险因素,治疗方法和组织学发现.
主要成果:
- 胸前动脉在87%的患者中受到影响. 在28%的患者中观察到快速进展 (≥5毫米/年).
- 快速进展的扩张与较高的动脉瘤性疾病患病率 (p=0.04) 和增加使用他类药物 (p=0.04) 和抗血小板药物 (p=0.02) 相联系.
- 在患有主动性主动脉炎的患者中,85%的患者在炎症部分发生了扩张,所有具有可用的组织学的FP患者都表现出活性血管炎.
结论:
- 大动脉炎症,特别是活跃的血管炎,是GCA中大动脉扩张快速进展的重要因素.
- 动脉瘤性疾病也可能导致GCA患者的动脉扩张加速.
- 这些发现突显了GCA相关的大动脉并发症中炎症和动脉样硬化之间的相互作用.
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