摘要
目的：认识抗中性粒细胞胞浆抗体（ＡＮＣＡ）相关小血管炎的临床表现。方法：对近二年来检出的５６例ＡＮＣＡ相关小血管炎患者的临床病理资料进行分析总结，系统描述全身，特别是肾外临床表现。结果：５６例中男３１例，女２５例，平均年龄５３（９～７８）岁。ｃＡＮＣＡ阳性１３例，均识别ＰＲ３；ｐＡＮＣＡ阳性４３例，其中３８例识别ＭＰＯ。临床上表现为多器官损害，肾脏受累占９６４％，约半数表现为急性肾功能衰竭；肺脏受累占７５％，其中半数以上表现为肺出血和（或）肺部阴影，少数表现为肺间质纤维化、肺内结节和薄壁空洞；４７６％有关节痛；３５７％有肌肉痛；３８１％有皮疹；２６２％眼受累，表现为各种炎症病变；１６７％耳受累；２８６％有消化道症状。全身表现中发热占７０８％、体重下降占３１０％。实验室检查８１６％的患者有贫血，多为中重度贫血；半数患者ＷＢＣ计数增高；１００％患者有血沉快。本研究中仅不足１／５患者在发病一个月内得到确诊。结论：ＡＮＣＡ相关小血管炎临床呈多系统损害，肾脏最易受累，肾外以肺脏为著，多表现为肺出血或肺部阴影。其它脏器如关节肌肉、皮肤、眼耳等均可受累。ＡＮＣＡ相关小血管炎患者多有贫血、血沉明显增快。?
OBJECTIVE ToanalyzetheclinicalmanifestationsofpatientswithANCArelatedvasculitis METHODOLOGY Clinicalandpathologicaldatawerecollectedform56patientswithANCArelatedvasculitis,theirsystemic,especiallyextrarenalmanifestationswereanalyzed. RESULTS Ofthe56patients,31weremaleand25werefemalewithanaverageageat53(978)yearsold.Thirteenofthe56werecANCA positive,allrecognizedPR3;theother43werepANCApositive,and38ofthe43recognizedMPO.Clinically,patientswithANCArelatedvasculitishadmultisystemicinvolvment.964%patientshadkidneyinvolvement;75%hadlunginvolvment,overhalfofthelunginvolvedhadpulmonaryhemorrhageand/orinfiltration,somehadpulmonaryfibrosis,nodulesorcavities;476%patientshadarthralgia;357%hadmusclepain;381%hadskinrash;262%hadeyeinvolvment;167%hadearinvolvmentand286hadgastrointestinalsymptoms.Also,708%patientshadfeverand310%ofthemhadbodyweightloss.Inlaboratoryexaminations,816%
出处
《肾脏病与透析肾移植杂志》
CAS
CSCD
1999年第3期210-211,共2页
Chinese Journal of Nephrology,Dialysis & Transplantation
基金
国家教委归国基金
关键词
抗中性粒细胞
胞浆抗体
小血管炎
系统表现
ANCAvasculitissystmicmeanifestationofthepatientshadanemia,overhalfhadanincreasedWBCcountandallhadanincreasedESR.Inthisstudy,onlylessthan20%ofthepatientswascorrectlydiagnosedasANCArelatedvasculitiswithinlmonth. CONCLUSION ANCArelatedvasculitiswasamultisy
