ANCA相关血管炎临床分析

Clinical analysis of fifty-six cases with ANCA associated vasculitis

目的探讨抗中性粒细胞胞浆抗体(ANCA)相关血管炎的临床特点。方法分析56例确诊ANCA相关血管炎患者的临床表现、实验室检查、活检病理及治疗情况。结果56例患者中有呼吸系统症状34例;肾脏损害42例;21例出现皮肤损伤;28例有骨关节肌肉病变;消化道症状16例;11例出现神经病变;5例视力下降,6例听力下降。心脏亦可累及。48/50例ANCA阳性。有32例活检病理支持诊断。所有患者用糖皮质激素或/和免疫抑制剂治疗。结论AN-CA相关小血管炎临床表现多种多样,最常累及呼吸系统、肾脏、骨关节肌肉及皮肤粘膜。ANCA及病理活检有助于本病诊断。糖皮质激素或/和免疫抑制剂治疗有效。

Objective To analyze the clinical manifestations of anfi-neutrophil cytoplasmic autoantibody（ANCA） associated vasculifis（ AAV） for improving the level of its clinical diagnosis. Methods The clinical symptoms, laboratory findings, pathological report of biopsy and outcome of treatment in 56 confirmed cases of AAV were collected and analyzed. Results Of. all fiftysix cases, 34 with respiratory symptoms; 42 with renal damages; 21 with skin damages; 28 with museuloskeletal manifestaions; 6 with digestive tmet symptoms; 11 with nerve system damages; Visual and hearing loss involvements were seen in 5 and 6 respectively, some eases with heart symptoms.48 eases were ANCA positive in 50 eases. Pathological examination of 32 cases comfirmed their AAV diagnosis.All eases were treated with glyeosteroid or/and immunosuppressive drug. Conclusion AAV patients usually show various clinical manifestations. The general clinical features of AAV were pulmonary, renal, musculoskeletal and cutaneous. ANCA and pathological examination were diagnostic tools. Glycosteroids or/and immunosuppressive drugs were effective therapy.