Characteristics of Older Patients with Takayasu’s Arteritis: A Two-Center, Cross-Sectional, Retrospective Cohort Study

Abstract Background Few studies have assessed elderly patients with Takayasu’s arteritis (TAK). Objectives To evaluate the progression of TAK in different age groups and its possible effects on drug treatment and disease activity. Methods This cross-sectional and retrospective cohort study included 66 TAK patients. Patients were interviewed and data of the 12 preceding months were collected from electronic medical records. The patients were divided into four quartiles according to current age and compared for clinical and laboratory data, treatment, comorbidities, disease status, and functional status. Statistical significance was set at p<0.05. Results The groups were Q1(22-36 years, n=16), Q2(37-42 years, n=18), Q3(43-49 years, n=17), and Q4(51-66 years, n=15). The frequency of patients with disease activity, fatigue, comorbidities and vascular impairments, and the TAK disease extent index were also comparable between the groups. With age, disease duration was longer (p=0.001), fewer patients used prednisone (Q1:43.8%, Q2:33.3%, Q3:11.8%, and Q4:6.7%; p=0.049) and immunosuppressive drugs [Q1:100.0%, Q2:66.7%, Q3:58.8%, and Q4:46.7%; Q1 versus Q3 (p=0.043), and Q1 versus Q4 (p=0.005) in post-hoc analyses], and patients had greater functional status impairment (Q2 versus Q3, p=0.003). In addition, the levels of disease damage, new TAK symptoms, and complications in the preceding 12 months were not different between the groups. Conclusions Older patients with TAK require minimal drug treatment, and have greater impairment of functional status, which may be attributed to aging-related factors.

研究背景 目前针对高安动脉炎（Takayasu’s arteritis, TAK）老年患者的相关研究较为匮乏。研究目的 评估不同年龄组高安动脉炎患者的疾病进展情况，及其对药物治疗与疾病活动度的潜在影响。研究方法 本研究为横断面回顾性队列研究，共纳入66例高安动脉炎患者。对患者进行访谈，并从电子病历中收集其入组前12个月的临床数据。根据当前年龄将患者分为四个四分位数组，对比各组的临床及实验室指标、治疗方案、合并症、疾病状态与功能状态。本研究设定统计学显著性阈值为p<0.05。研究结果 各组分别为Q1组（22~36岁，n=16）、Q2组（37~42岁，n=18）、Q3组（43~49岁，n=17）及Q4组（51~66岁，n=15）。各组间疾病活动患者占比、疲劳症状发生率、合并症与血管损伤发生率，以及TAK疾病范围指数均无显著差异。随着年龄增长，患者的病程显著延长（p=0.001）；使用泼尼松的患者比例逐渐降低（Q1：43.8%，Q2：33.3%，Q3：11.8%，Q4：6.7%；p=0.049），免疫抑制剂使用比例亦呈下降趋势[Q1：100.0%，Q2：66.7%，Q3：58.8%，Q4：46.7%；事后检验显示Q1与Q3（p=0.043）、Q1与Q4（p=0.005）组间差异具有统计学意义]，且患者的功能状态损伤程度更显著（Q2 vs Q3，p=0.003）。此外，各组在入组前12个月内的疾病损伤程度、新发TAK症状及并发症发生率均无显著差异。研究结论 高龄高安动脉炎患者所需药物治疗强度更低，但功能状态损伤程度更显著，这一表现可能与衰老相关因素有关。