论文部分内容阅读
目的对抗中性粒细胞胞质抗体相关性小血管炎(AASV)的发生、诊断及治疗进行讨论。方法总结收治的1例以脑卒中(言语不清、偏身麻木、力弱)为首发表现的AASV患者的临床特点、影像学和病理学资料,并结合文献予以回顾性分析。结果 AASV临床表现缺乏特异性,以脑卒中为首发症状的病例罕见。患者病程早期仅偏身力弱,入院时伴发热、镜下血尿等表现,通过反复进行抗中性粒细胞胞质抗体检验,考虑AASV可能性大;在短期内出现进行性肾功能不全时经肾脏穿刺病理学检查明确诊断。结论脑部AASV应筛查自身免疫相关指标,及早对病灶靶器官(脑、肾等)行病理活检,减少误诊。早期施治可改善患者预后。
Objective To discuss the occurrence, diagnosis and treatment of neutrophil cytoplasmic antibody associated vasculitis (AASV). Methods One case of AASV was retrospectively reviewed. The clinical features, imaging and pathology data of AASV patients with stroke (unclear speech, partial numbness and weakness) were retrospectively analyzed. Results AASV clinical manifestations of the lack of specificity, the first symptom of stroke in the rare cases. Patients with early only weak body weakness, admission with fever, microscopic hematuria and other performance by repeated anti-neutrophil cytoplasmic antibody test to consider the possibility of AASV large; in the short term progressive renal insufficiency Renal puncture pathology to confirm the diagnosis. Conclusions AASV in the brain should be screened for autoimmune related indicators and pathological biopsy should be performed on target organ (brain, kidney, etc.) as early as possible to reduce misdiagnosis. Early treatment can improve the prognosis of patients.