Retrospective Clinical Study of Patients with Takayasus Arteritis
Objective: To study the clinical features angiographic findings, treatment response and prognosis of patients with Takayasu arteritis. Methods: Seventy-three patients with Takayasu arteritis admitted into our hospital between January 2006 and August 2011 were evaluated retrospectively for the clinical manifestations, laboratory testings, angiographic findings, treatment response and prognosis of the disease. Results: There were twenty male cases, 53 female cases of 73 patients with Takayasu arteritis, the ratio of male to female was 1:3.8. The mean age of onset was (33.9±12.0) years old (yo), and the median age at onset of first symptoms of the disease was 26 yo (range 14-63 yo). Five patients of them were less than 18 yo, and 22 patients were over 40 yo. The incidences of dizziness, malaise, hypertension, acrotism or pulseless, vascular bruits and asymmetric blood pressure were present separatively in 60%, 40%, 70%, 30%, 72% and 54%. Angiographic findings showed that Typeâ (36%)ï¼Type â £(23%)ï¼Typeâ ¤(25%) were common, and Typeâ ¡a (1%), Typeâ ¡b (7%), Type â ¢ (8%) were seldom seen. Disease activity of Takayasu arteritis should be evaluated according to level of elevated erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP), which were present in 33% and 37% of patients, respectively. Fifty-eight patients underwent different angiographies, 29 of them accepted the stenting implantation. Ten interventions (34.5%) restenosed (31.4±11.7%) months after intervention. Seventy patients (96%) received Aspirin (100mg/d) therapy, three patients (4%) received clopidogrel at a daily dose 75mg, twenty-four of them received glucocorticoids with immunosuppressive agents and 14 patients received glucocorticoids alone. Of patients with intervention, non-intervention and restenosis, there was no difference in mean age (P=0.25), ESR (P=0.47) and CRP (P=0.98); whereas, there was statistically significant difference in mean age (P=0.007), ESR (P=0.044) and CRP (P=0.001), among patients with glucocorticoids and immunosuppressive agents, none of them and alone. Conclusions: Clinical signs and symptoms of patients with Takayasu arteritis (TA) were atypical in the early stage. Physicians should increase awareness to prevent delay diagnosis in TA. Angiography was the gold standard for diagnosis. Sedimentation rate (ESR) and C-reactive protein (CRP) contributed to guide the treatment of patients with TA and evaluate the disease activity.
Chao-Fei Zhou, Ming-Zhi Shen, Geng Qian, Yi-Hong Ren*