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Neurology:Aβ相关血管炎或为中枢神经系统血管炎不同亚型

2013-10-31 佚名 丁香园

该研究的目的是分析脑血管淀粉样蛋白β沉积伴与不伴验性血管浸润的临床表现、治疗效果及临床预后。 研究连续随机纳入1987年至2011年25年终罗切斯特梅奥临床中心78例脑血管Aβ沉积患者。由神经病理学家回顾性分析40例不伴炎症的脑血管Aβ沉积患者(CAA脑淀粉样血管病),28例肉芽肿性血管炎(Aβ相关血管炎或ABRA),10例血管周围CAA相关炎症。该研究同时随机纳入1

该研究的目的是分析脑血管淀粉样蛋白β沉积伴与不伴验性血管浸润的临床表现、治疗效果及临床预后。

研究连续随机纳入1987年至2011年25年终罗切斯特梅奥临床中心78例脑血管Aβ沉积患者。由神经病理学家回顾性分析40例不伴炎症的脑血管Aβ沉积患者(CAA脑淀粉样血管病),28例肉芽肿性血管炎(Aβ相关血管炎或ABRA),10例血管周围CAA相关炎症。该研究同时随机纳入1983年至2007年共25年间118例原发性中枢神经血管炎不伴Aβ沉积患者。

与40例脑淀粉样血管病患者相比,28例Aβ相关血管炎患者诊断时更年轻,认知改变较轻,神经缺损症状较轻,颅内出血更少,但是就诊时钆增强脑膜强化更强,最终随访致残率和死亡率更低。与原发性中枢神经血管炎相比,28例ABRA患者诊断时年龄更大,认知改变、癫痫发作、脑膜强化和颅内出血的发生率更高,偏瘫、视力障碍和MRI显示脑梗塞的发生频率更低,脑脊液蛋白水平更高。Aβ相关血管炎和原发性中枢神经血管炎的治疗结果和预后相似。

Aβ相关血管炎的表现与原发性中枢神经血管炎有很多相似之处,或为原发性中枢神经血管炎的不同亚型。

研究背景:

原发性中枢神经系统血管炎又称为中枢神经系统肉芽肿性血管炎。这种血管炎没有全身其他部位的血管炎和其他炎症表现,血管炎改变只局限在中枢神经系统的血管。在脑血管造影、脑组织活检技术被用于临床之前,该病容易被忽视。Aβ相关血管炎是由Aβ淀粉样蛋白沉积导致的血管炎症改变,其与原发性中枢神经血管炎的关系尚不明确。

原文出处:

Salvarani C, Hunder GG, Morris JM, Brown RD Jr, Christianson T, Giannini C.Aβ-related angiitis: Comparison with CAA without inflammation and primary CNS vasculitis.Neurology. 2013 Oct 29;81(18):1596-603. doi: 10.1212/WNL.0b013e3182a9f545. 

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    2014-06-18 yinhl1978
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    2013-11-02 膀胱癌
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