肺血管炎361例临床分析

Clinical analysis of pulmonary vasculitis in 361 patients

目的探讨肺血管炎的临床特点。方法回顾性分析361例肺血管炎患者的临床资料,观察疾病特点及在民族、性别等方面的差异。结果肺血管炎女性发病率(85.6%)高于男性(14.4%)(P<0.05),汉族、维吾尔族、哈萨克族和回族肺血管炎发病率(54.8%、28.3%、11.9%、4.99%)比较差异无统计学意义(P>0.05);咳嗽、发热为肺血管炎常见临床症状,其中121例有多脏器受累,可继发于系统性红斑狼疮、类风湿性关节炎、干燥综合征等疾病;肺部高分辨率CT可见网状改变、肺泡病变、囊状改变及结节改变;抗中性粒细胞胞质抗体阳性63例(17.5%)。结论肺血管炎发生率在民族间未发现存在差异,多见于女性,临床症状不典型,有多脏器受累的特点;动态检测抗中性粒细胞胞质抗体或行组织活检病理检查有助于疾病的诊断。

Objective To explore the clinical characteristics of pulmonary vasculitis.Methods The clinical data of 361 patients with pulmonary vasculitis were retrospectively analyzed to observe the characteristics of the disease and the differences in nationalities and genders.Results The incidence of pulmonary vasculitis was higher in female patients（85.6%）than that in male patients（14.4%）（P〈0.05）.There were no significant differences in the incidences among Han,Uygur,Hazakh and Hui patients（54.8%,28.3%,11.9%,4.99%）（P〈0.05）.Cough and fever were the most common symptoms of pulmonary vasculitis.In 361 patients,121were involved multiple organ damage,and some patients were complicated with secondary systemic lupus erythemic,rheumatoid arthritis and Sjgren syndrome.Reticular degeneration,alveolar lesion,cystic change and nodular change were visible on high resolution CT.Antineutrophil cytoplasm antibody was positive in 63patients（17.5%）.Conclusion Pulmonary vasculitis is more common in females than in males,and has the characteristics of atypical clinical symptoms and multiple organ involvement.There is no significant difference in the incidence among ethnic groups.Dynamic detection of antineutrophil cytoplasm antibodies or tissue biopsy is helpful to the diagnosis.