Clinical Presetations Of Takayasu's Arteritis: An Analysis On 57 Cases

Objective:To investigate the clinical characteristics of Takayasu' s arteritis patients with distal areas of artery affected and compare the difference between the proximal and distal affeted patients in clinical manifestations and treatment effect.Method:A retrospective analysis was carried on the clinic date of 57 Takayasu' s arteritis patients admitted into Peking Union Medical College hospital from Jan of 2007 to Jan of 2008.Only patients meeting the American College of Rheumatology criteria for TA were included.All the Patients who had alredy taken the CTA examination were divided into group one and group two.The group one patients were only affected the proximal section of the arteries,while the group two with both the proximal and distal sections.Data were collected by means of an ad hoc form.Demographic information, clinical history,vascular findings and treatment of two groups were analyzed.Results:In our series of patients,the ratio of the group one and two was 1:1.28. The time of the two groups from the initial symptoms to TA diagnosis was(12±14) months and(25±31) months respectively(P<0.05).More group two patients had their disease onset with non-specific symptoms like headache(37.5%and 12.0% respectively),as well as the symptoms of claudication,weight loss and urination problems subsequently.64%of the group one patients and 37.5%of the group two patients had elevated CRP(P<0.05).The time of initial therapy of prednisone varied from 4 to 7(median 4.4)weeks in group one,while group two varing from 2 to 4(median 3.0)weeks.The age at onset and the major complications was similar between the two groups,but as for the proportions of anatomic types,more group one patiens were typeⅠthan the group two(P<0.05).Conclusion:Patients with distal areas of artery affected in Takayasu' s arteritis are common.This type of Takayasu' s arteritis is atypical in clinical manifestation and immunology examination.Delay in diagnosis is an important issue for it,so attention should be paid to it in clinical diagnosis and treatment.