病理阳性的巨细胞动脉炎患者的临床特点及其与病理结果的相关性

目的总结颞动脉活检阳性的巨细胞动脉炎(GCA)患者的临床特点及其与阳性病理结果的相关因素。方法回顾性复习北京协和医院自1997年1月至2017年12月行颞动脉活检的巨细胞动脉炎(GCA)住院的46例患者的临床资料,并根据病理结果将患者分成两组,进行两组间的分析比较。结果病理阳性组的年龄明显高于阴性组,而病程则明显比阴性组短。临床表现中,阳性组的头皮触痛、肌痛和非特异性症状明显高于阴性组(P<0.05),而听力下降则低于阴性组(P<0.05)。既往史中,病理阳性组有吸烟史和肿瘤家族史的明显少于阴性组(P<0.05)。实验室检查中,病理阳性组的淋巴细胞数和血色素明显低于阴性组(P<0.05)。进行多元logistic回归检验,分析淋巴细胞数为阳性病理结果的独立相关因素。结论颞动脉活检病理阳性组与阴性组在年龄、病程、头皮触痛、肌痛、非特异性症状和听力下降、吸烟史、肿瘤家族史等存在的差异有统计学意义,而淋巴细胞数为病理结果的独立影响因素。

Clinical characteristics of biopsy-positive giant cell arteritis and the relevance with the positive pathology results

Objective To summarize the characteristics of biopsy-positive giant cell arteritis patients and the relevance with positive biopsy results. Methods The data of the giant cell arteritis in-patients were retrospectively analyzed who underwent the temporal artery biopsy from January 1997 to December 2017. The clinical characteristics of the patients with a positive were compared with those with a negative biopsy result. Results Twenty-six of 46 biopsies were positive for giant cell artery and 19 negative. The biopsy-positive group had higher age and shorter course. Percentage of scalp tenderness,myalgia and non-specific manifestations were higher, while hearing loss was lower in positive group. The patients in positive group had less smoking history and tumor history, and lower lymphocytes and hemoglobin. Only lymphocyte count (odds ratio 0.205) was independent predictor of the biopsy results. Conclusions The group with positive temporal artery biopsy result has significantly different characteristics as compared to negative group. The number of lymphocytes is an independent influencing factor to the pathologic result of temporal artery biopsy.