·256·中华内科杂志2023年3月第62卷第3期Chin J Intern Med.March2023.Val.62.No.3标准与讨论·风湿性多肌痛和巨细胞动脉炎的诊疗规范王培·冯学兵2段兴旺3刘升云4赵岩5代表中华医学会风湿病学分会'郑州大学人民医院河南省人民医院风湿免疫科，郑州450003；2南京大学医学院附属鼓楼医院风湿免疫科，南京210008；3南昌大学第二附属医院风湿免疫科，南昌330006：4郑州大学第一附属医院风湿免疫科，郑州450052；5中国医学科学院北京协和医学院北京协和医院风湿免疫科国家皮肤与免疫疾病临床医学研究中心疑难重症及罕见病国家重点实验室风湿免疫病学教育部重点实验室，北京100730通信作者：刘升云，Email:2693372345@qg.com;赵岩，Email:zhaoyan_.pumch2002@aliyun.com【摘要】风湿性多肌痛(PMR)是一种以颈部、肩胛带和骨盆带肌肉疼痛、晨僵，红细胞沉降率升高，伴或不伴发热等全身反应为表现的综合征。巨细胞动脉炎(GCA)是一种原因不明的几乎全身血管均可受累的系统性血管炎，主要侵犯大、中动脉，病变呈节段性、坏死性，组织病理学呈肉芽肿样炎症。我国目前尚缺乏GCA的流行病学资料，实际患病率可能被低估。GCA较为严重的并发症是不可逆的视觉丧失及脑血管事件。PMR发病率为GCA的3倍，临床上需排除其他特异性疾病。GCA患者中40%~60%合并PMR,PMR患者中约15%合并GCA。为推进GCA和PMR的规范化诊断与治疗，中华医学会风湿病学分会在2005年临床诊疗指南的基础上，借鉴国内外诊治经验和指南，制定了本规范，旨在规范GCA和PMR的诊断和治疗，改善患者预后。【关键词】风湿性多肌痛；巨细胞动脉炎：诊断；治疗；预后Recommendations of diagnosis and treatment of giant cell arteritis and polymyalgiarheumatic in ChinaWang Pei,Feng Xuebing',Duan Xingwang',Liu Shengyun',Zhao Yan,on behalf of ChineseRheumatololgy AssociationDepartment of Rheumatology and Immunology,People's Hospital of Zhengzhou University,HenanProvincial People's Hospital,Zhengzhou 450003,China;Department of Rheumatology andImmunology,the Affiliated Drum Tower Hospital of Nanjing University Medical School,Nanjing210008,China;Department of Rheumatology,the Second Affiliated Hospital of Nanchang University,Nanchang 330006,China;'Department of Rheumatology and Immunology,the First Affiliated Hospitalof Zhengzhou University,Zhengzhou 450052,China;'Department of Rheumatology and ClinicalImmunology,Peking Union Medical College Hospital,Peking Union Medical College,Chinese Academy ofMedical Sciences,National Clinical Research Center for Dermatologic and Immunologic Diseases,Ministry of Science Technology,State Key Laboratory of Complex Severe and Rare Diseases,KeyLaboratory of Rheumatology and Clinical Immunology,Ministry of Education,Beijing 100730,ChinaCorresponding authors:Liu Shengyun,Email 2693372345@qq.com;Zhao Yan,Emailzhaoyan_pumch2002@aliyun.comAbstract Polymyalgia rheumatica (PMR)is a syndrome characterized by pain andmorning stiffness in the neck and shoulder and pelvic girdles,as well as raised acute-phasereactants,with or without systemic symptoms,such as fever.Giant cell arteritis (GCA)is a systemicD01:10.3760/cma.i.cnl12138-20221020-00773收稿日期2022-10-20本文编辑胡朝晖引用本文：王培，冯学兵，段兴旺，等.风湿性多肌痛和巨细胞动脉炎的诊疗规范[中华内科杂志，2023，62(3:256-266.D0L:10.3760/ema.j.cn112138-20221020-00773.
