抗中性粒细胞胞浆抗体小血管炎24例临床分析

Clinical analysis of 24 cases of antineutraphil cytoplasmic antibody associated small vasculitis

目的对我院24例抗中性粒细胞胞浆抗体小血管炎患者的临床资料进行临床分析。方法对确诊为抗中性粒细胞胞浆抗体小血管炎患者的临床表现、实验室检查、肾脏病理、诊治及预后进行分析。结果24例患者均为抗中性粒细胞胞浆抗体（ANCA）阳性，均有肾脏受累，同时还伴有肺、胃肠道、眼、耳、鼻、声带、皮肤、关节、甲状腺及外周神经受累。临床表现复杂多样，平均确诊时间为（9±4）个月。治疗以糖皮质激素加用环磷酰胺为主。总缓减率为78％。结论抗中性粒细胞胞浆抗体小血管炎为多系统受累疾病，漏诊误诊率高，早期诊治能提高生存率，但部分患者预后不佳。

Objective In this study,we have analyzed the clinical characters of ASV in ourhospital. Methods The clinical manifestation, laboratory test, renal pathology, diagnosis, treatment and prognosis were analyzed. Results The ANCA of all 24 cases was positive. The clinical manifestations were complicated and varied symptoms of multi system involvements which included kidney,lung, gastroentero, ear, nose, vocal cords, skin,joint, thyroid and nerven system. The average diagnostic time was （ 9 ± 4） months. The remission rate was 78% when glucocorticoid was used in combination with cyclophosphamide in the treatment. Conclusion ASV is a multi-organs involved disease with high misdignostic and missed rate. Early diagnosis and treatment are very important to improve the survival rate.