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目的分析儿童多发性大动脉炎临床特点及治疗转归,提高对此病的认识。方法研究对象为1990~2002年在北京协和医院住院并确诊为儿童多发性大动脉炎的患儿28例,对其临床表现、实验室及影像学检查、治疗转归进行回顾性分析。结果28例中男7例,女21例,男女比例1∶3,年龄1.5~18岁,确诊时病程15d至6年。常见的临床症状为血管杂音25例(89.3%),高血压14例(50.0%),无脉或脉弱19例(67.8%),头痛等19例(67.8%);动脉造影22例,其中I型(8例,36.4%)和Ⅴ型为主(6例,27.3%);炎症活动指标主要为血沉升高20例(71.4%),C反应蛋白升高12例(42.8%),WBC升高10例(35.7%)。28例中23例接受激素和(或)免疫抑制剂治疗,有效率91.3%,11例无病情活动但有严重并发症者行外科手术或介入治疗后好转。结论对于多系统、多脏器损害的疾病,应全面检查,尤其是四肢血压、脉搏及血管杂音,注意大动脉炎的可能,早期诊断是提高治疗效果的关键。
Objective To analyze the clinical features and prognosis of children with multiple arteritis and to raise awareness of the disease. Methods Twenty-eight children hospitalized at Peking Union Medical College Hospital from 1990 to 2002 and diagnosed as having multiple childhood arteritis were retrospectively analyzed. The clinical manifestations, laboratory and imaging findings and treatment outcome were retrospectively analyzed. Results 28 males and 7 females, 21 females, male to female ratio of 1: 3, aged 1.5 to 18 years, the duration of diagnosis of 15d to 6 years. Common clinical symptoms were vascular shunt in 25 cases (89.3%), hypertension in 14 cases (50.0%), no pulse or pulse weakness in 19 cases (67.8%), headache in 19 cases (67.8%), angiography in 22 cases Type I (8 cases, 36.4%) and type V were predominant (6 cases, 27.3%). Inflammatory index mainly included elevated erythrocyte sedimentation rate (ESR) of 20 (71.4%), elevated C-reactive protein Elevated in 10 cases (35.7%). Of the 28 patients, 23 received steroid and / or immunosuppressive therapy, with an effective rate of 91.3%. Eleven patients who did not have disease activity but had serious complications were cured after surgery or intervention. Conclusion For multi-system, multi-organ damage diseases, should be comprehensive examination, especially the limbs blood pressure, pulse and vascular murmur, pay attention to the possibility of aortic arteritis, early diagnosis is the key to improving the therapeutic effect.