【摘要】 目的　研究巨细胞动脉炎的神经系统临床特征。方法　对诊断为巨细胞动脉炎的 2 9例患者 ,根据临床表现、颞动脉活检、类固醇激素治疗效果和随访结果作为诊断标准 ,以 1990年美国风湿病学会 (ACR)制定的巨细胞动脉炎诊断标准作为参考。结果　 2 9例患者被诊断为巨细胞动脉炎 ,其中有 2 2例符合ACR诊断标准。每例至少有一种以上神经系统方面的临床症状或体征 ,其中头痛 2 7例 ,视力改变 10例 ,脑卒中 7例 ,眼睑下垂 5例 ,失眠 5例 ,头晕 4例 ,易疲劳 3例 ,下颌跛行 3例 ,意识障碍 2例 ,呕吐 2例 ,癫发作 1例 ,震颤 1例。经类固醇治疗后其症状或体征常在数小时至数天消失。本组≥ 6 0岁患者明显低于 <6 0岁患者 ,差异有显著性意义。结论　巨细胞动脉炎的神经系统症状与体征较为常见 ,可导致严重的并发症 ,早期诊断、治疗可得到有效控制。更多还原

【Abstract】 Objective To investigate the neurologic manifestations of giant cell (temporal) arteritis (GCA).Methods The diagnosis of GCA in twenty-nine patients from July 1999 to June 2003 was based on the clinical manifestations,temporal artery biopsy,response to steroid therapy,and follow-up data.The American College of Rheumatology(ACR) criteria for classification of GCA were used as reference.Results Thirty-eight patients who sought medical advice in the Second Hospital Affiliated to Xiangya Medical College were suspected of GCA.A definite diagnosis of GCA was made in twenty-nine patients.The diagnosis in 22 of them fulfilled the 1990 American College of Rheumatology criteria for the classification of GCA.Every one of the twenty-nine patients had at least one kind of neurologic symptom or sign.They included newly occurring headache in 27 cases,vision change in 10 cases,apoplexy in 7 cases,ptosis in 5 cases,insomnia in 5 cases,dizziness in 4 cases,fatigue in 3 cases,jaw claudication in 3 cases,consciousness disturbance in 2 cases,vomiting in 2cases,seizure in 1 case and tremor in 1 case,which mostly disappeared a few hours to days after steroid hormone was given.The cases of giant cell arteritis were less in the patients over 60 years old than in those under 60 years,with significant difference.Conclusion The neurologic manifestations were common in GCA,which might result in severe complications such as vison loss and stroke,and which can be effectively controlled by early diagnosis and early steroid hormone treatment.更多还原