血管炎周围神经病

Vasculitic neuropathies

血管炎周围神经病是炎性细胞浸润周围神经血管引起神经缺血损伤所致,其典型临床表现为伴有疼痛的多发性单神经病,根据血管炎累及范围分为系统性和非系统性。尽管本病为一种可治疗性的周围神经病,但不同类型血管炎的预后差异很大。周围神经活组织检查(活检)是诊断血管炎周围神经病的重要手段,在急性期、慢性期、缓解期可呈现不同的病理特征。早期应用激素联合免疫抑制剂治疗可改善预后。文中对血管炎周围神经病的分类、临床及电生理表现、诊断、治疗及预后等方面进行介绍,旨在增加读者对该疾病的认识。

Vasculitic neuropathies occur when inflammatory cells infiltrate the vessels of peripheral nerves.Patients with vasculitic neuropathies typically present with multiple mononeuropathies(also known as multifocal neuropathy),characterized by the acute-to-subacute onset of painful sensory and motor deficits.Vasculitic neuropathies could develop in the setting of systemic vasculitis.It also could present as a non-systemic vasculitis without other organs involvement.Peripheral nerve biopsy has an important role in the diagnosis of vasculitic neuropathies.In this review,the classification,clinical and electrophysiological manifestations,diagnosis,treatment,and prognosis of vasculitic neuropathies are summarized,with a focus on recent progresses in these areas.