摘要
目的 研究肺脏受累的原发性小血管炎的临床特点和早期诊断要点 ,减少其误诊率。方法 对 2 6例原发性小血管炎伴肺脏受累患者的临床资料进行回顾性分析。结果 2 6例中 ,显微镜下多血管炎 (MPA) 15例 ,韦格纳肉芽肿 (WG) 9例 ,变应性肉芽肿性血管炎 (CCS) 2例。抗中性粒细胞胞浆抗体 (ANCA)阳性率 6 1.5 %。肺脏受累的临床表现有咯血、呼吸困难、干咳、胸痛、胸闷等 ,胸部 X线多表现为多发斑片状或点状阴影、大片高密度阴影或团块影、结节影、网格状影 ,可有空洞形成。疾病早期多误诊为肺部感染、肿瘤、肺间质病变等。应用肾上腺皮质激素和环磷酰胺治疗肺部病变可明显吸收 ,临床危重症得以改善。结论 伴肺脏受累的原发性小血管炎临床表现复杂多样 ,诊断困难 ,误诊率高 ,易延误病情 ,须引起临床医师的重视。
Objective To investigate the clinical characteristics of primary small vessel vasculitis with involvement of lungs and analyze the cause of misdiagnosis of it.Methods Clinical data from 26 patients with primary small vessel vasculitis were collected and their pulmonary manifestations were further analyzed.Results The patients with lung involvement had cough,hemoptasis,dyspnea,chest pain and asthma.Findings on lung X-ray films were variable.Some showed multiple patch shadows,some showed single or multiple masses or nodular shadows with or without cavity formation.Among them 61.5% were antineutrophil cytoplasmic antibody(ANCA) positive.The treatments with corticosteroid and CTX were effective in these cases,in particularly,pulmonary lesions improved obviously.Conclusions It is very difficult to make diagnosis of primary small vessel vasculitis with involvement of lungs and this should be paid more attentions.
出处
《山东医药》
CAS
北大核心
2004年第28期8-9,共2页
Shandong Medical Journal
