Semin Arthritis Rheu:巨细胞动脉炎中的动脉病变

2018-05-14 xiangting MedSci原创

诊断为GCA的所有患者均应进行动脉成像,至少应对基线异常的患者进行连续成像检查。

这项研究旨在评估巨细胞动脉炎(GCA)患者连续成像时的大血管(LV)异常,并识别新病变的预测因子。

研究纳入前瞻性、多中心、纵向研究和/或随机临床试验的GCA患者(包括通过LV成像诊断的受试者),收集这些患者的临床和影像学数据。新动脉病变定义为先前未受影响的动脉出现的病变。

这项研究纳入187例GCA患者,其中146例(78%)女性,诊断时的平均年龄(±SD)为68.5±8.5岁;39%由LV影像学诊断。第一次研究中123例患者(66%)存在至少1个动脉病变。最常受累的动脉是锁骨下(42%)、腋窝(32%)、胸主动脉(20%)。在连续成像的106例患者(57%)中,平均(±SD)随访4.39(2.22)年,有41例患者(39%)出现新动脉病变,这41例患者均有基线异常。第2年33%患者出现新异常;这些病例中仅有50%存在活动性疾病的临床特征。有和没有新病变患者的年龄、性别、颞动脉活检阳性或疾病活动性不存在差异。

在这个GCA患者队列中,首次影像学检查时的LV异常很常见。新动脉病变出现在首次影像检查时有动脉异常的患者,通常没有活动性疾病的症状。诊断为GCA的所有患者均应进行动脉成像,至少对基线异常的患者进行连续成像检查。

原始出处:
Tanaz A. Kermani, et al. Arterial Lesions in Giant Cell Arteritis: A Longitudinal Study. Semin Arthritis Rheu. 09 May 2018.

本文系梅斯医学(MedSci)原创编译整理,转载需授权!

版权声明:
本网站所有内容来源注明为“梅斯医学”或“MedSci原创”的文字、图片和音视频资料,版权均属于梅斯医学所有。非经授权,任何媒体、网站或个人不得转载,授权转载时须注明来源为“梅斯医学”。其它来源的文章系转载文章,或“梅斯号”自媒体发布的文章,仅系出于传递更多信息之目的,本站仅负责审核内容合规,其内容不代表本站立场,本站不负责内容的准确性和版权。如果存在侵权、或不希望被转载的媒体或个人可与我们联系,我们将立即进行删除处理。
在此留言
评论区 (4)
#插入话题
  1. [GetPortalCommentsPageByObjectIdResponse(id=1972482, encodeId=ae7119e2482ef, content=<a href='/topic/show?id=8a6a2e8839' target=_blank style='color:#2F92EE;'>#Arthritis#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2788, encryptionId=8a6a2e8839, topicName=Arthritis)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTIibticIBly5jCSic5ZElW4He3rO4DMpUHUFaFX57OicNMnzckWaicBNeStwugWHFCuOdicoakApM4HGmtw/132, createdBy=f8672500006, createdName=ms6390871039024434, createdTime=Tue Oct 09 22:46:00 CST 2018, time=2018-10-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1683180, encodeId=b29b1683180cb, content=<a href='/topic/show?id=60f03325e28' target=_blank style='color:#2F92EE;'>#动脉炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=33257, encryptionId=60f03325e28, topicName=动脉炎)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=d22a27947071, createdName=xsm927, createdTime=Wed Feb 20 02:46:00 CST 2019, time=2019-02-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1356782, encodeId=ce351356e82e6, content=<a href='/topic/show?id=b0702e84b9' target=_blank style='color:#2F92EE;'>#ART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2784, encryptionId=b0702e84b9, topicName=ART)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Wed May 16 00:46:00 CST 2018, time=2018-05-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1502218, encodeId=078b150221899, content=<a href='/topic/show?id=021d4821096' target=_blank style='color:#2F92EE;'>#巨细胞#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=48210, encryptionId=021d4821096, topicName=巨细胞)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=11759518880, createdName=wwzzly, createdTime=Wed May 16 00:46:00 CST 2018, time=2018-05-16, status=1, ipAttribution=)]
  2. [GetPortalCommentsPageByObjectIdResponse(id=1972482, encodeId=ae7119e2482ef, content=<a href='/topic/show?id=8a6a2e8839' target=_blank style='color:#2F92EE;'>#Arthritis#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2788, encryptionId=8a6a2e8839, topicName=Arthritis)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTIibticIBly5jCSic5ZElW4He3rO4DMpUHUFaFX57OicNMnzckWaicBNeStwugWHFCuOdicoakApM4HGmtw/132, createdBy=f8672500006, createdName=ms6390871039024434, createdTime=Tue Oct 09 22:46:00 CST 2018, time=2018-10-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1683180, encodeId=b29b1683180cb, content=<a href='/topic/show?id=60f03325e28' target=_blank style='color:#2F92EE;'>#动脉炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=33257, encryptionId=60f03325e28, topicName=动脉炎)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=d22a27947071, createdName=xsm927, createdTime=Wed Feb 20 02:46:00 CST 2019, time=2019-02-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1356782, encodeId=ce351356e82e6, content=<a href='/topic/show?id=b0702e84b9' target=_blank style='color:#2F92EE;'>#ART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2784, encryptionId=b0702e84b9, topicName=ART)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Wed May 16 00:46:00 CST 2018, time=2018-05-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1502218, encodeId=078b150221899, content=<a href='/topic/show?id=021d4821096' target=_blank style='color:#2F92EE;'>#巨细胞#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=48210, encryptionId=021d4821096, topicName=巨细胞)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=11759518880, createdName=wwzzly, createdTime=Wed May 16 00:46:00 CST 2018, time=2018-05-16, status=1, ipAttribution=)]
    2019-02-20 xsm927
  3. [GetPortalCommentsPageByObjectIdResponse(id=1972482, encodeId=ae7119e2482ef, content=<a href='/topic/show?id=8a6a2e8839' target=_blank style='color:#2F92EE;'>#Arthritis#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2788, encryptionId=8a6a2e8839, topicName=Arthritis)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTIibticIBly5jCSic5ZElW4He3rO4DMpUHUFaFX57OicNMnzckWaicBNeStwugWHFCuOdicoakApM4HGmtw/132, createdBy=f8672500006, createdName=ms6390871039024434, createdTime=Tue Oct 09 22:46:00 CST 2018, time=2018-10-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1683180, encodeId=b29b1683180cb, content=<a href='/topic/show?id=60f03325e28' target=_blank style='color:#2F92EE;'>#动脉炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=33257, encryptionId=60f03325e28, topicName=动脉炎)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=d22a27947071, createdName=xsm927, createdTime=Wed Feb 20 02:46:00 CST 2019, time=2019-02-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1356782, encodeId=ce351356e82e6, content=<a href='/topic/show?id=b0702e84b9' target=_blank style='color:#2F92EE;'>#ART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2784, encryptionId=b0702e84b9, topicName=ART)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Wed May 16 00:46:00 CST 2018, time=2018-05-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1502218, encodeId=078b150221899, content=<a href='/topic/show?id=021d4821096' target=_blank style='color:#2F92EE;'>#巨细胞#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=48210, encryptionId=021d4821096, topicName=巨细胞)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=11759518880, createdName=wwzzly, createdTime=Wed May 16 00:46:00 CST 2018, time=2018-05-16, status=1, ipAttribution=)]
    2018-05-16 zhaojie88
  4. [GetPortalCommentsPageByObjectIdResponse(id=1972482, encodeId=ae7119e2482ef, content=<a href='/topic/show?id=8a6a2e8839' target=_blank style='color:#2F92EE;'>#Arthritis#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2788, encryptionId=8a6a2e8839, topicName=Arthritis)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTIibticIBly5jCSic5ZElW4He3rO4DMpUHUFaFX57OicNMnzckWaicBNeStwugWHFCuOdicoakApM4HGmtw/132, createdBy=f8672500006, createdName=ms6390871039024434, createdTime=Tue Oct 09 22:46:00 CST 2018, time=2018-10-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1683180, encodeId=b29b1683180cb, content=<a href='/topic/show?id=60f03325e28' target=_blank style='color:#2F92EE;'>#动脉炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=33257, encryptionId=60f03325e28, topicName=动脉炎)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=d22a27947071, createdName=xsm927, createdTime=Wed Feb 20 02:46:00 CST 2019, time=2019-02-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1356782, encodeId=ce351356e82e6, content=<a href='/topic/show?id=b0702e84b9' target=_blank style='color:#2F92EE;'>#ART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2784, encryptionId=b0702e84b9, topicName=ART)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Wed May 16 00:46:00 CST 2018, time=2018-05-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1502218, encodeId=078b150221899, content=<a href='/topic/show?id=021d4821096' target=_blank style='color:#2F92EE;'>#巨细胞#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=48210, encryptionId=021d4821096, topicName=巨细胞)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=11759518880, createdName=wwzzly, createdTime=Wed May 16 00:46:00 CST 2018, time=2018-05-16, status=1, ipAttribution=)]
    2018-05-16 wwzzly

相关资讯

英国NHS同意罗氏的RoActemra(IL-6抗体)治疗巨细胞动脉炎

在英国NHS的成本监管机构的最后审批同意后,Roche的RoActemra将在未来三个月内为患有巨细胞动脉炎(GCA)的成年人定期提供。

BMJ:巨细胞动脉炎——案例报道

患者女,74岁,有肠癌和高血压史,持续额部疼痛数周,因咀嚼会加剧下颌疼痛,患者的饮食摄入差;此外患者还有左眼间歇性视力模糊,三天前完全丧失视力。患者自觉嗜睡增加、全身肌肉疼痛。查体:双侧颞动脉无搏动。左眼眼底检查:与视网膜中央动脉阻塞表现一致。最初的血液测试显示:炎症标志物:C反应蛋白(CRP)2438 nmol / L,红细胞沉降率(ESR)116mm/h;血小板588×109/L。对患者及时处

N Engl J Med:托珠单抗能减少巨细胞动脉炎激素逐渐减量期间的复发

长期糖皮质激素治疗虽然是巨细胞动脉炎的首选方案,但减量过程中容易复发。2017年7月,发表在《N Engl J Med》的一项研究显示,对于巨细胞动脉炎患者的持续无激素缓解,每周或每隔周接受1次托珠单抗,联合26周强的松逐渐减少优于26周或52周强的松逐渐减少联合安慰剂。

巨细胞动脉炎发病机制研究进展

巨细胞动脉炎(giant cell arteries,GCA),又名颖动脉炎或肉芽肿性动脉炎,是一种以侵犯大动脉及其主要分支为主的节段性、坏死性血管炎,伴肉芽肿形成,有淋巴细胞、巨噬细胞、多核巨细胞(multinucleated giant cells,位于病变动脉内膜和中层交界处,由多个巨噬细胞融合形成)浸润,一般无纤维素样坏死,多见于50岁以上人群,病变主要位于富含内弹力膜和滋养血管的主动

Arthritis Rheumatol:确诊巨细胞动脉炎的第一年内的感染和死亡风险增加

近期发表在Arthritis & Rheumatology的研究称,诊断巨细胞动脉炎第一年内,有更高的感染和感染相关死亡风险。法国Amiens大学医院的J. Schmidt博士和同事对486名巨细胞动脉炎(GCA)患者进行了研究,按年龄和性别匹配对照组,随访5年。数据显示,GCA组和对照组相比,严重感染的发生率比(IRR)为2.1(95% CI, 1.2-3.4;两组发生率分别为11.1/

喜讯!FDA授予罗氏抗炎药Actemra/RoActemra第2个突破性药物资格,治疗巨细胞动脉炎(GCA)

瑞士制药巨头罗氏(Roche)抗炎药Actemra/RoActemra(tocilizumab,托珠单抗)近日在美国监管方面传来喜讯。FDA已授予Actemra/RoActemra治疗巨细胞动脉炎(GCA)的突破性药物资格(BTD),这也是该药在美国监管方面获得的第2个突破性药物资格,之前,FDA于2015年6月授予该药治疗系统性硬化症(SSc)的BTD。值得一提的是,此次BTD,也是罗氏自2