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Arthritis Rheumatol:巨细胞动脉炎的诊断评估策略和疾病亚群

2019-11-25 xiangting MedSci原创

血管成像越来越多地被纳入GCA的诊断评估中,并根据颞动脉和颅外动脉受累来识别患者的临床亚群。

随着血管成像技术的日益普及,巨细胞动脉炎(GCA)的诊断评估正在迅速发生变化。这项研究目的是确定GCA临床亚群是否具有不同的特征或反映不同的诊断评估。

从一个国际性队列中招募患者,并根据颞动脉(TA)异常[TA活检阳性(TAB)或TA超声的光晕征(TA-US]/或大血管LV)受累的影像学证据将其分为四个亚群:1TA异常和LV受累[TA+/LV+GCA]2)没有大血管受累的TA异常[TA+/LV-GCA]3)大血管受累,无TA异常[TA-/ LV+GCA];和4临床诊断的GCA,无大血管受累或TA异常[TA/LVGCA]

72个国际研究中心招募了941GCA患者。大多数患者进行了多种形式的诊断评估,包括TABn=70475%);TA‐USn=32835%); LV成像(n=53457%)。66%的TAB79%的TA-US40%的LV成像证实了GCAGCA亚群具有不同的特征,与诊断评估策略无关。TA+/LV-)是最常见的亚群(51%),颅脑缺血负担较高。TA/LV)(26%)颅脑缺血和肌肉骨骼症状的患病率高。TA/LV+)(12%)上肢血管异常多见,视力丧失患病率低。TA+/LV+)(11%)的年龄较大,颅脑缺血、全身症状的患病率高和急性期反应物升高。

血管成像越来越多地被纳入GCA的诊断评估中,并根据颞动脉和颅外动脉受累来识别患者的临床亚群。

原始出处:

K. Bates Gribbons. Diagnostic Assessment Strategies and Disease Subsets in Giant Cell Arteritis: Data from an International Observational Cohort. Arthritis Rheumatol. 14 November 2019.

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    2020-09-15 xsm927
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    2019-11-27 zhaojie88
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    2019-11-27 wwzzly

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