原发性系统性血管炎90例临床分析

Clinical analysis of 90 cases of primary systemic vasculitis

目的分析原发性系统性血管炎(PSV)的临床特点,以便提高临床诊断水平。方法回顾性收集2006～2011年中南大学湘雅二医院住院的90例PSV患者临床资料。分析PSV的临床表现和实验室特点。结果 90例原发性血管炎(PVS)患者平均年龄(46±18)岁,男女比例为46∶44,病程(8±12)月,以肾脏受累(67.7%,40/90)、皮肤黏膜受累(58.1%,36/90)和呼吸系统受累(51.6%,32/90)为主要表现。抗中性粒细胞胞浆抗体(ANCA)阴性患者皮肤黏膜受累的发生率显著高于阳性患者P<0.05);ANCA阳性患者CRP较ANCA阴性患者CRP增高更显著(P<0.05),其他指标无明显差异(P>0.05)。结论原发性系统性血管炎的临床表现复杂多样,以肾脏、皮肤、呼吸系统受累为主,不同血管炎在实验室检查、影像学检查及病理检查上有一定的特异性,尤其ANCA在早期诊断中意义重大。

To analyze the clinical characteristics of Primary Systemic Vasculitis（PSV） to improve the level of its clinical diagnosis.【Methods】We retrospectively analyzed the clinical manifestations and laboratory results of 90 PSV patients which attended the Department of Rheumatology,the Second Xiangya Hospital of Central South University from 2006 to 2011.【Results】Of the 90 PSV patients,age 46±18 years,male to female rate of 46： 44,with the duration of 8 ±12 months,the mainly involved systems were renal（67.7%,40/90）,skin and mucosa（58.1%,36/90）,respiratory system（51.6%,32/90）,the prevalence of skin and mucosa involvement was significantly lower in patients with Antineutrophil Cytoplasmic Antibodies（ANCA） positive than those with ANCA negative（P 0.05）;the prevalence of CRP positive was significantly higher in patients with ANCA positive than those with ANCA negative（P 0.05）,but other laboratory results were not.【Conclusions】The clinical manifestations are complicated and various in PSV,the mainly involved systems are renal,skin and mucosa,respiratory system.There are some specificity in different forms of PSV in laboratory tests,imaging and pathological examinations,particularly ANCA is important in the early diagnosis.