抗中性粒细胞胞浆抗体相关性血管炎的心血管病变的研究进展

Overview of cardiac involvement in ANCA-associated vasculitis

抗中性粒细胞胞浆抗体相关性血管炎(AAV)是一种系统性小血管炎,它可引起多器官损害(如急危重肾衰和肺出血),其病死率较高。然而,AAV的心血管受累较少见,其主要表现为血管狭窄、动脉瘤、主动脉夹层、主动脉破裂、主动脉反流等损害。在其3种临床分型中,嗜酸性肉芽肿血管炎的心脏损害最为常见,而在显微镜下多血管炎中心脏受累发生率最低。另外,血管炎的治疗过程(包括诱导期和维持期)中所用药物可能对患者在原发病基础上发生心血管病变产生影响。然而,对于AAV累及心血管的发病机制仍需进一步研究。

Antineutrophil cytoplasmic antibody（ANCA）-associated vasculitis（AAV）is a systemic small-vessel vasculitis,which usually presents with multi-organ damage such as life-threatening kidney failure or pulmonary hemorrhage,causing a high mortality rate.However,cardiac involvement in AAV is rare and may present as arterial stenosis,aneurysmal disease,aortic dissection,aortic rupture,and aortic regurgitation.Of the three clinical types of AAV,cardiac involvement is the most common in eosinophilic granulomatosis（EGPA）while has been scarcely occurred in microscopic polyangiitis（MPA）.Moreover,drugs used in the therapy of vasculitis including induction agents and maintenance agents may influence the risk of developing cardiovascular events in AAV patients.However,the pathogenesis of cardiac involvement in AAV requires further studies.