ANCA阳性脑梗死患者临床特征分析

Analysis of clinical features in ANCA-positive patients with cerebral infarction

目的:分析抗中性粒细胞胞浆抗体(ANCA)阳性脑梗死患者的临床表现、临床特征。方法:收集我院神经内科经ANCA检测的1297例脑梗死患者的病例资料,并进行回顾性分析。根据ANCA检测结果,患者被分为ANCA阴性组(1166例)和ANCA阳性组(131例)。比较两组再发脑梗死发生率、临床表现和临床特征。结果:与ANCA阴性组比较,ANCA阳性组再发脑梗死发生率(35.08%比70.99%)、呼吸道感染(37.39%比54.96%)、肺间质病变比例(25.21%比33.59%)均显著升高,P<0.05或<0.01。两组的消化道症状、泌尿系感染、肺结节和鼻窦炎/副鼻窦炎比例无显著差异,P均>0.05。结论:ANCA阳性的脑梗死患者复发率高,且早期合并呼吸道感染率较高,提示临床针对此类患者应及早检测ANCA,及时采取措施控制病情进展。

Objective:To analyze clinical manifestations and feature of antineutrophil cytoplasmic antibody(ANCA)positive patients with cerebral infarction(CI).Methods:Case data of 1297 CI patients,who underwent ANCA detection from our department of neurology,were collected and retrospectively analyzed.According to ANCA detection outcome,patients were divided into ANCA negative group(n=1166)and ANCA positive group(n=131).Incidence rate of recurrent CI,clinical manifestations and feature were compared between two groups.Results:Compared with ANCA negative group,there were significant rise in incidence rate of recurrent CI(35.08%vs.70.99%),percentages of respiratory infection(37.39%vs.54.96%)and pulmonary interstitial disease(25.21%vs.33.59%)in ANCA positive group,P<0.05 or<0.01.There were no significant difference in percentages of gastrointestinal symptoms,urinary tract infections,pulmonary nodules and sinusitis/parasinusitis between two groups,P>0.05 all.Conclusion:Recurrence rate is high in ANCA positive CI patients,and their early complicated respiratory infection rate is higher,suggesting ANCA detection should be performed early in these patients and corresponding measures should be taken to control disease progress.