大动脉炎（Takayasu’s disease）是一种好发于亚洲育龄期妇女的未明确病因的罕见、原发性全身血管慢性肉芽肿性血管炎，年发病率为2~3人/百万人（男女患病率比为1∶8.5），又称Takayasu病或无脉症，病因不明，可能与遗传因素有关，主要累及主动脉及其分支，其组织病理学特点为主动脉及其分支血管内膜增殖、纤维化，动脉壁中层的弹力纤维层变性。血管炎症导致血管壁增厚、狭窄、狭窄后扩张、动脉瘤和血栓形成。该病最终可导致主动脉及其主要分支大血管闭塞或形成动脉瘤，进展很难预测，但大部分患者病程进展较为缓慢，视网膜炎、继发性高血压、主动脉返流和动脉瘤等常预示该病预后较差。该病的药物治疗主要为控制血管炎症和控制高血压［1］。妊娠合并大动脉炎的情况鲜有报道，本文现报道4例妊娠合并大动脉炎患者的围术期管理，并进行文献回顾。

Takayasu’s arteritis is a rare, idiopathic, chronic inflammatory disease. Its course is unpredictable, but slow progression is usual, leading to stenosis, occlusion, or aneurismal degeneration of the aorta or its major branches. We present the anesthesia management of pregnancy in four women admitted to Peking University Third Hospital for caesarean section from year 2006 to 2015 complicated with Takayasu’s arteritis and review this disease with special reference to natural history, diagnostic criteria, classification, prognostic factors, and anesthesia considerations. Anesthesiological data were retrospectively analyzed for clinical manifestations, anesthesia process, perioperative complications, and pregnancy outcome. One patient received only epidural anesthesia, while the other three patients received combined spinal and epidural anesthesia (CSEA). Surgeries for all the four patients were successful with stable vital signs. We found comprehensive examinations including whether the disease was in the active phase and the clinical classification of the disease before conception was recommended for patients diagnosed with Takayasu’s arteritis. CSEA and continuous epidural block could be both used as anesthesiological method in patients with Takayasu’s arteritis. During the surgery, to avoid rapid hemodynamic fluctuations and protect the major organs’ function is very essential to allow for a satisfactory outcome.