29例丙硫氧嘧啶引起抗中性粒细胞胞浆抗体阳性患者的临床特征及治疗分析

Analysis of Clinical Features and Treatment of 29 Patients with PTU-induced Positive ANCA

目的:分析我院29例由丙硫氧嘧啶(PTU)引起的抗中性粒细胞胞浆抗体(ANCA)阳性患者的临床特点,观察甲巯咪唑(MMI)替代治疗出现ANCA相关性小血管炎(AASV)患者的改善情况。方法:29例的临床资料,采用一般临床检查和实验室检查,对其临床表现、治疗和预后进行回顾性分析。结果:ANCA阳性而无临床症状16例(55.2%),出现AASV的患者13例(44.8%),其中环核型ANCA(pANCA)阳性患者肾受累的发生率(50.0%)高于胞浆型ANCA(cANCA)阳性患者(40.0%);采用MMI替代治疗1年后ANCA转阴率66.7%。结论:由PTU引起的AASV,采用MMI替代治疗后,病情得到改善。

OBJECTIVE： To analyze the clinical characteristics of 29 patients with PTU-induced positive antineutrophil cytoplasmic antibody （ANCA）, and to investigate the effects of replacement treatment of MMI on ANCA-associated small vessel vasculitis （AASV）. METHODS： By general clinical examination and laboratory examination, clinical information of 29 positive ANCA cases were analyzed retrospectively in respect of their clinical manifestations, treatment and prognosis. RESULTS： No clinical manifestation was found in 16 cases of PTU induced positive ANCA （55.2%） ; AASV was found in 13 cases （44.8%） ; the incidence of renal involvement in patients with pANCA （50.0%） were significantly higher than those with cANCA （40.0%） ; MMI could relieve the ANCA at a rate of 66.7%. CONCLUSION： Replacement treatment of MMI can relieve PTU-induced AASV.