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Takayasu's arteritis H1964

1. Á¤ÀÇ

aortic arch¿Í ±× branch¸¦ ÁַΠħ¹üÇÏ´Âmedium- and large-sized arteryÀÇ inflammatory

and stenotic diseaseÀÌ´Ù. aortic arch¸¦ ÁַΠħ¹üÇϹǷΠaortic arch syndromeÀ̶ó°íµµ

ÇÑ´Ù.

2. ¹ß»ý ¹× À¯º´

Takayasu's arteritis´Â µå¹®ÁúȯÀ̸ç temporal arteritisº¸´Ù ´ú ÈçÇÏ´Ù.

û¼Ò³â±â ÀþÀº ¿©ÀÚ¿¡¼­ °¡Àå ¸¹ÀÌ ¹ß»ýÇÑ´Ù.

µ¿¾çÀο¡¼­ ´õ ÈçÇÏÁö¸¸ ƯÁ¤ Á¾Á·À̳ª Áö¿ª¿¡ ±¹ÇѵÇÁö ¾Ê´Â´Ù.

3. º´Å»ý¸® ¹× º´ÀÎ

* Tab317-5: °¡Àå Àß Ä§¹üµÇ´Â Ç÷°ü ¹× ÀÓ»óƯ¡

subclavian(mc) > common carotid > abdominal aorta > renal

aorta major branchÀÇ Ä§¹üÀº ¿øÀ§ºÎº¸´Ù´Â originÇÏ´ÂÀå¼Ò¿¡ ´õ µÎµå·¯Áø´Ù.

inflammatory mononuclear cell infiltration(°£È¤ giant cells)À» µ¿¹ÝÇÏ´Â panarteritisÀ̸ç

marked intimal proliferation and fibrosis, media scarring & vascularization, elastic laminaÀÇ

disruption & degradationÀ» º¸ÀδÙ. thrombosisÀÇ À¯¹«¿Í »ó°ü¾øÀÌ luminal narrowingÀÌ

¹ß»ýÇÑ´Ù.

vasa vasorumÀÌ ÈçÈ÷ ħ¹üµÈ´Ù.

4. ÀÓ»ó ¹× °Ë»ç½Ç ¼Ò°ß

Takayasu's arteritis´Â ±¹¼ÒÁõ»óÀ» ÀÏÀ¸Å³ »Ó¸¸ ¾Æ´Ï¶ó Àü½ÅÀû Áõ»óµµ ÀÏÀ¸Å²´Ù.

Àü½ÅÀû Áõ»óÀ¸·Î´Â malaise, fever, night sweats, arthralgias, anorexia, and wt loss µîÀÌ

ÀÖ´Ù.À̵é Áõ»óÀº Ç÷°üħ¹üÀÌ ÀÖ±âÀü¿¡ ³ªÅ¸³ª±âµµ ÇÑ´Ù. ħ¹ü Ç÷°ü, ƯÈ÷ subclavian artery

°¡ ħ¹üµÇ¾úÀ» ¶§ pulse´Â ÈçÈ÷ ¾ø´Ù.

ÀÓ»óÀû °æ°ú´Â Àü°Ý¼ºÀϼöµµ ÀÖ°í, ¼­¼­È÷ ÁøÇàÇÒ¼öµµ ÀÖ°í, stabilizeÇÒ¼öµµ ÀÖ´Ù. ÇÕº´ÁõÀº

ħ¹üÇ÷°üÀÇ ºÐÆ÷¿Í °ü·ÃÇÏ¿© ¹ß»ýÇϴµ¥ »ç¸ÁÀº ÁÖ·Î congestive heart failure¿Í CVA¿¡

ÀÇÇÑ´Ù.

Ư¡ÀûÀÎ °Ë»ç½Ç ¼Ò°ßÀº ESRÀÇ Áõ°¡, mild anemia, immunoglobulin levelÀÇ Áõ°¡ÀÌ´Ù.

5. Áø´Ü

Áø´ÜÀÇ ½ÃÀÛÀº ÀþÀº ¿©ÀÚ¿¡°Ô¼­ peripheral pulse°¡ °¨¼ÒÇϰí Ç÷¾ÐÀÇ ºÒÀÏÄ¡, arterial bruit°¡

µé¸±¶§ °­·ÂÇÏ°Ô ÀǽÉÀ» ÇÏ´Â °ÍÀÌ´Ù. Áø´ÜÀº Ư¡ÀûÀÎ arteriographic patternÀ¸·Î ÇÑ´Ù.

: irregular vessel walls, stenosis, poststenotic dilatation, aneurysm formation, occlusion,

evidence of increased collateral circulation

½ÅÀå¿¡ ±Ý±â°¡ ¾ø´Ù¸é arterial diseaseÀÇ Á¤µµ¿Í ºÐÆ÷¸¦ ¿ÏÀüÈ÷ ÆÄ¾ÇÇϱâ À§ÇØ complete

aortic arteriography¸¦ ½ÃÇàÇØ¾ß ÇÑ´Ù.

6. Ä¡·á

º¸°íµÈ »ç¸Á·üÀº 10%¹Ì¸¸¿¡¼­ 70%±îÁö ´Ù¾çÇÏ´Ù. ºñ·Ï glucocorticoid 40-60mg/day°¡

Áõ»óÀ» ¿ÏÈ­ÇÏÁö¸¸ ´Üµ¶À¸·Î »ýÁ¸·üÀ» Çâ»ó½ÃŰ´ÂÁö¿¡ ´ëÇÑ È®Á¤ÀûÀÎ ¿¬±¸´Â ¾ø´Ù.

glucocorticoid¿Í ÇùÂøÇ÷°ü¿¡ aggressive surgical and/or angioplastic approachÀÇ º´ÇÕÄ¡·á

·Î »ýÁ¸·üÀÇ »ó´çÇÑ Çâ»ó°ú strokeÀ¸·Î ÀÎÇÑ morbidity, renal artery stenosis·Î ÀÎÇÑ °íÇ÷¾Ð,

ischemic viscera and limbÀ¸·ÎÀÇ blood flowÇâ»óÀ» °¡Á®¿Ô´Ù°í º¸°íÇÏ¿´´Ù. ÀÌ·¯ÇÑ Ä¡·á¸¦

ÅëÇÏ¿© ´ëºÎºÐÀÇ ÃÖ±Ù »ç¸Á·üÀº 10%¹Ì¸¸ÀÌ´Ù.

glucocorticoid¿¡ ¹ÝÀÀÇÏÁö ¾Ê´Â »ç¶÷Àº methotrexate 25mgÀ» ÁÖ 1ȸ »ç¿ëÇÏ¿© ÁÁÀº °á°ú¸¦

¾ò¾ú´Ù. ±×·¯³ª confirmÇϱâ À§Çؼ­´Â long-term study°¡ ÇÊ¿äÇÏ´Ù.