ANCA相关性小血管炎肾损害17例临床分析

Small ANCA Associated Vasculitis Renal Damage of 17 Cases of Clinical Analysis

目的:分析抗中性粒细胞胞浆抗体(ANCA)相关性小血管炎肾损害的临床特点及激素和环磷酰胺治疗该病的疗效。方法:回顾性分析17例ANCA相关性小血管炎肾损害患者的临床特点,8例使用激素治疗,9例使用激素和环磷酰胺(CTX)治疗。比较两组患者治疗6个月、12个月后的血尿、蛋白尿、血肌酐和尿素氮水平。结果:17例ANCA相关性小血管炎肾损害患者的临床表现复杂多样,累及多个系统,均累及肾脏。两组治疗前、后相比,(P+C)组血尿、蛋白尿、血肌酐下降水平明显高于P组,差异有统计学意义(P<0.05)。结论:ANCA相关性小血管炎临床表现为多系统受累,诊断需结合临床表现、ANCA检测等检查,做到早期诊断。激素联合环磷酰胺治疗ANCA相关性小血管炎肾损害能增强疗效。

Objective：To analysis clinical characteristics of the small ANCA associated vasculitis renal damage,hormones and cyclophosphamide treatment the curative effect of small ANCA associated vasculitis renal damage.Methods：Retrospective analysis of 17 cases of small ANCA associated vasculitis clinical characteristics of patients with renal damage,8cases of using hormone therapy,9cases using hormones and cyclophosphamide（CTX）therapy.Compare two groups of 6months and 12 months after treatment in patients with hematuria,proteinuria,serum creatinine and urea nitrogen levels.Results：17patients with small ANCA associated vasculitis renal damage of complex and varied clinical manifestations,involving multiple systems,all involving the kidneys.Compared the two groups before and after treatment,hormone and cyclophosphamide group hematuria,proteinuria,serum creatinine levels decrease significantly higher than that of control group,difference between the two groups was statistically significant（P0.05）.Conclusion：Small ANCA associated vasculitis clinical manifestations of multiple systems involved,the diagnosis should be combined with the clinical manifestation,ANCA detection and so on.early diagnosis.Hormone combined therapy with cyclophosphamide small ANCA associated vasculitis renal damage can enhance curative effect.