动脉活检:了解低阳性率的原因
Stella-Marie Girard1, Caroline François2,1,3
1Plastic and Reconstructive Surgery, Christian Cabrol Hospital, Reims, FRA.
Cureus
|May 5, 2025
概括
动脉活检显示巨细胞动脉炎的阳性率较低. 临床诊断往往有所不同,突出显示了对这种疑似霍顿的细化指示和技术的需要.
科学领域:
- 血管外科 血管外科
- 类风湿病学 类风湿病学
- 病理学 病理学 病理学
背景情况:
- 巨细胞动脉炎 (GCA) 的诊断依赖于临床怀疑和动脉活检 (TAB).
- 临床诊断和活检结果之间的不一致是GCA管理中已知的挑战.
研究的目的:
- 为了比较TAB产量与涉嫌GCA的转诊医生的临床诊断.
- 确定与积极的TAB结果相关的因素.
主要方法:
- 对72名因疑似GCA接受TAB治疗的患者进行回顾性分析研究 (2021年1月 - 2024年12月).
- 分析患者的因素,症状和手术/病理变量.
- 活检阳性率与最终临床诊断的比较.
主要成果:
- TAB阳性率为16.6% (12/72). 这是一个很好的结果.
- 总体健康状况恶化与阳性活检显著相关 (OR = 3.71,p = 0.05).
- 医生在55.5%的病例中诊断出霍顿病,通常与活检结果不一致.
结论:
- 在疑似GCA中存在显著的解剖临床矛盾,受病理学和诊断/手术变异性的影响.
- 需要改进的指示和改进的外科手术技术用于TAB.
- 对于强烈怀疑霍顿病的病例,应保留TAB,建议从表面动脉分支上游取样.
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