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咯血合并肾小球肾炎称为肺出血-肾炎综合征(Goodpasture综合征),其中3/4病例伴有肾小球基膜(GBM)自身抗体。肺出血为何只在抗GBM肾炎中存在尚不清楚,本文提示在抗-GBM肾炎中肺出血的发生与吸烟有密切关系。研究对象为51例有肾小球肾炎的临床及形态学证据并出现抗-GBM抗体的患者,其中45例经肾活检诊断为抗-GBM病。男28例,女23例,年龄在4～72岁。肺出血的诊断标准:咯血;或无咯血者至少符合以下3项标准中的2项即胸片示特征性的肺泡阴影,24小时内血红蛋白浓度下降至少2g/dl而无其他原因;单次呼吸一氧化碳常数(KCO)从原来的稳定水平急性升高至少30％。
Hemoptysis associated with glomerulonephritis is known as Goodpasture’s syndrome, with 3/4 cases associated with glomerular basement membrane (GBM) autoantibodies. Why pulmonary hemorrhage only exists in anti-GBM nephritis is unclear, this paper suggests that anti-GBM nephritis in the occurrence of pulmonary hemorrhage and smoking are closely related. Fifty-one patients with clinical and morphologic evidence of glomerulonephritis and anti-GBM antibodies were identified, and 45 of them were diagnosed with anti-GBM disease by renal biopsy. 28 males and 23 females, aged 4 to 72 years old. The diagnostic criteria for pulmonary hemorrhage: hemoptysis; or no hemoptysis at least meet the following three criteria 2 of the chest X-ray characteristic alveolar shadows, 24 hours hemoglobin concentration decreased at least 2g / dl for no other reason; a single breath The carbon monoxide constant (KCO) is an acute increase of at least 30% from the original stable level.