TEMPORAL ARTERITIS - A GENERALIZED VASCULAR DISEASE
TEMPORAL ARTERITIS - A GENERALIZED VASCULAR DISEASE
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DOI：
10.1093/qjmed/15.57.47
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发表时间：
1946-01-01
影响因子：
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通讯作者：
COLBECK, JC
中科院分区：
文献类型：
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作者：
COOKE, WT;CLOAKE, PCP;COLBECK, JC
我们的论点是，在老年人中存在一种广泛存在的动脉疾病，这种疾病并不罕见，但很少被认识到，在这种疾病中，出现了特征性的动脉和明显的局部征象，病变动脉管壁的炎性和退行性变化产生了一幅特征性的组织学图像。我们呈现的综合征与1932年由Horton、Magath和Brown首次描述的颞动脉炎是相同的。他们报告了两个病例；第一个是58岁的女性，患有严重的头痛和发炎的压痛的颞动脉；第二个是68岁的男性，主诉虚弱，额头疼痛，头皮有痛处，颈腺增大，颞动脉压痛。对这些动脉切除部分的显微镜检查，对症状的考虑，以及明显的自限病程，使他们假设该综合征代表了一种新的疾病实体。在过去的12年里，至少报告了30起病例。症状相当一致，出现在55岁以上的患者中。在一些病例中，它们提示全身动脉受累，但直到最近还没有尸检证据证明这一点。Sproul(1942)简要报告了其中一例的病理发现，而Gilmour(1941)以巨细胞性动脉炎为标题，记录了三例类似的病例。Chasnoff和Vorzmer(1944)也描述了一例尸检时显示弥漫性动脉改变的病例的临床细节。我们观察了7名年龄在66岁至73岁之间的患者，其中3名男性和4名女性(表1)。其中6例患者的首发症状为全身不适、肌肉酸痛和关节痛、食欲不振和体重减轻。几个月后，一个病例中有9个，出现了更明显的症状。所有病例在某一时间都有严重的头痛。有两个案例出现了一段时间的精神混乱。在6例中，可能在第7例中，颞动脉显示血栓形成。3例患者完全失明，1例失明
OUR thesis is that there exists in elderly people a widespread arterial disease, not uncommon but rarely recognized, in which characteristic arterial and striking local signs occur, and in which inflammatory and degenerative changes in the walls of the affected arteries produce a characteristic histological picture. The syndrome we present appears identical with temporal arteritis, first described by Horton, Magath, and Brown in 1932. They reported two cases; the first, a woman of 58 years, suffered with severe headaches and inflamed and tender temporal arteries, the second, a man aged 68 years, complained of weakness, pain over the forehead, tender areas in the scalp, and had enlarged cervical glands and tender temporal arteries. Microscopical examination of excised portions of these arteries, consideration of the symptoms, and the apparently self-limiting course of the disease led them to postulate that the syndrome represented a new disease entity. Over the past 12 years at least 30 cases have been reported. The symptoms have been fairly uniform and occurring in patients over the age of 55 years. In some they have been suggestive of generalized arterial involvement, but until recently there has been no autopsy proof of this. Sproul (1942) reported briefly the pathological findings in one such case, whilst Gilmour (1941), under the title giant cell arteritis, has recorded three similar cases. Chasnoff and Vorzimer (1944) have also described the clinical details of a case which they stated showed diffuse arterial changes at autopsy. We have had under observation seven patients with the disease between the ages of 66 and 73 years, three male and four female (Table 1). The onset of the illness in six of the cases was with general malaise, myalgia and arthralgia, anorexia, and loss of weight. After some months, nine in one case, more striking symptoms appeared. Headache was severe at some time in all the cases. Mental confusion was present in two cases for a period. In six cases, and probably in the seventh, the temporal arteries showed thrombosis. Three patients suffered complete loss of sight, one loss of sight in one