[1]苏 抗,陈希胜.ANCA相关性血管炎肺部临床特征研究[J].医学信息,2020,33(18):109-113.[doi:10.3969/j.issn.1006-1959.2020.18.036]
　SU Kang,CHEN Xi-sheng.Study on the Clinical Characteristics of ANCA-associated Systemic Vasculitis[J].Medical Information,2020,33(18):109-113.[doi:10.3969/j.issn.1006-1959.2020.18.036]
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ANCA相关性血管炎肺部临床特征研究()
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医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
33卷
期数:
2020年18期
页码:
109-113
栏目:
临床研究
出版日期:
2020-09-15

文章信息/Info

Title:
Study on the Clinical Characteristics of ANCA-associated Systemic Vasculitis
文章编号:
1006-1959（2020）18-0109-05
作者:
苏 抗; 陈希胜
（北京市顺义区医院呼吸内科，北京 101300）
Author(s):
SU Kang; CHEN Xi-sheng
(Department of Respiratory Medicine,Shunyi District Hospital,Beijing 101300,China)
关键词:
ANCA 相关性血管炎; 抗中性粒细胞胞浆抗体; 肺部
Keywords:
ANCA-associated systemic vasculitis; Anti-neutrophil cytoplasmic antibody; Lung
分类号:
R593.2
DOI:
10.3969/j.issn.1006-1959.2020.18.036
文献标志码:
A
摘要:
目的 探讨抗中性粒细胞胞浆抗体相关性小血管炎（AASV）患者肺脏受累的临床特征，以提高对AASV的认识及诊断水平。方法 回顾性分析2015年3月~2019年9月于北京市顺义区医院确诊为AASV的23例住院患者的临床资料，分析其一般资料、临床表现、实验室检查、肺部影像学检查、病例活检、预后等情况。结果 23例患者疾病首发症状方面，9例为呼吸系统症状、11例为泌尿系统症状、1例为神经系统症状、1例为消化系统症状、1例为骨关节症状；肺部表现主要为咳嗽（69.57%）、咳痰（65.22%）、胸闷（65.22%）、气短（43.48%）、呼吸困难（34.78%）、咳血（21.74%）及肺间质病变（34.78%）等；实验室检查显示均有C反应蛋白和血沉升高，大部分有中性粒细胞升高（69.57%）、贫血（65.22%），23例中抗中性粒细胞胞浆抗体（ANCA）均为核周型抗中性粒细胞胞浆抗体（p-ANCA）阳性（100.00%）；肺外表现主要为发热（65.22%）、乏力（50.00%）、肾脏受累（95.65%）等；给予激素及免疫抑制剂治疗后病情好转20例（86.96%）；无效3例（13.04%），患者均死亡，1例因弥漫性肺泡出血死于失血性休克，1例因激素及免疫抑制剂使用后出现重症感染死亡，1例因肾衰竭死亡。结论 AASV临床表现无显著特异性，大多具有多脏器、多系统受累的特点，其中以肾脏及肺脏累及最为多见，对于长期发热同时合并多器官受损的患者应尽早进行ANCA 检查，及早诊断，及时治疗，以改善患者预后。
Abstract:
Objective To explore the clinical features of lung involvement in patients with anti-neutrophil cytoplasmic antibody-associated small vasculitis (AASV) in order to improve the understanding and diagnosis of AASV.Methods The clinical data of 23 inpatients diagnosed with AASV in Shunyi District Hospital of Beijing from March 2015 to September 2019 were retrospectively analyzed, and their general data, clinical manifestations, laboratory examinations, lung imaging examinations, and cases were analyzed biopsy, prognosis, etc.Results In 23 patients, the first symptoms of the disease were respiratory symptoms in 9 cases, urinary system symptoms in 11 cases, neurological symptoms in 1 case, digestive system symptoms in 1 case, and bone and joint symptoms in 1 case; lung manifestations were mainly cough (69.57%), expectoration (65.22%), chest tightness (65.22%), shortness of breath (43.48%), dyspnea (34.78%), hemoptysis (21.74%) and interstitial lung disease (34.78%), etc.; laboratory examination showed that C-reactive protein and erythrocyte sedimentation rate were elevated, most of which had elevated neutrophils (69.57%) and anemia (65.22%). Among the 23 cases, anti-neutrophil cytoplasmic antibodies (ANCA) were all pernuclear type antineutrophil cytoplasmic antibody (p-ANCA) positive (100.00%); extrapulmonary manifestations are mainly fever (65.22%), fatigue (50.00%), kidney involvement (95.65%), etc.; hormones and immunosuppression are given 20 patients (86.96%) improved after drug treatment; 3 patients (13.04%) were ineffective, all patients died, 1 patient died of hemorrhagic shock due to diffuse alveolar hemorrhage, and 1 patient developed severe infection after using hormones and immunosuppressants death, 1 case died of renal failure.Conclusion The clinical manifestations of AASV had no significant specificity, and most of them had the characteristics of multi-organ and multi-system involvement. Among them, kidney and lung involvement were the most common. For patients with long-term fever and multiple organ damage, ANCA examination should be performed as soon as possible for early diagnosis,timely treatment to improve the prognosis of patients.

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更新日期/Last Update: 1900-01-01