脊椎动脉参与巨细胞动脉炎:症状,治疗和结果
Johann Lambeck1, Axel Schläger2, Nils Venhoff3
1Department of Neurology and Neurophysiology, Medical Center, University of Freiburg, Breisacher Strasse 64, 79106 Freiburg, Germany.
概括
影响脊椎动脉 (VA) 的巨细胞动脉炎 (GCA) 不常见但严重. 由于VA+GCA患者中风进展和复发的风险,早期的密集治疗至关重要.
科学领域:
- 神经学 神经学
- 血管医学 血管医学
- 类风湿病学 类风湿病学
背景情况:
- 涉及脊椎动脉 (VA) 的巨细胞动脉炎 (GCA) 是缺血性中风的罕见原因.
- 对于VA+GCA患者的长期临床和超声波疗程的了解仍然很少.
研究的目的:
- 调查GCA和脊椎动脉干扰 (VA+) 患者的长期临床和超声波结果.
主要方法:
- 对怀疑GCA的患者进行超声波 (美国) 的12年后期分析.
- 专注于通过GCA特定的US识别的VA+患者,并从医院记录中提取后续数据.
主要成果:
- 在220名GCA患者中,74人 (34%) 是VA+. 19%的VA+患者出现了脊髓底性缺血症,严重的VA闭塞性疾病更为频繁.
- 在34名VA+患者的随访中,美国患者发现静脉狭窄的稳定 (38%),回归 (41%) 或进展 (21%).
- 12%的患者经历了反复的脊椎基性中风,其中3次发生在治疗开始后30天内.
结论:
- 三分之一的骨GCA病例涉及VA,具有显著的中风风险,特别是在严重的闭塞性疾病中.
- 狭窄症进展的高率和复发性中风需要对VA+GCA进行迅速,密集的免疫抑制治疗.
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