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目的分析显微镜下多血管炎(MPA)的临床特点,提高对该病的认识水平。方法回顾性分析18例MPA患者的临床表现、实验室检查、病理改变、治疗及预后。结果18例MPA患者中肾脏受累占94.4%,肺脏受累占66.7%,还可累及消化道、肌肉关节和神经系统等。94.4%的患者MPO-ANCA阳性,88.9%的患者血沉加快,77.8%的患者C反应蛋白增高,44.4%的患者白细胞增多,33.3%的患者血小板增多。激素和环磷酰胺为主要治疗方法,诱导期总缓解率为73.3%。结论MPA临床表现呈多器官受累,以肾脏和肺脏受累最为多见,临床误诊率较高,AN-CA检测对提高MPA的检出率具有重要意义。
Objective To analyze the clinical features of microscopic polyangiitis (MPA) and to improve the level of understanding of the disease. Methods Retrospective analysis of 18 cases of MPA patients with clinical manifestations, laboratory tests, pathological changes, treatment and prognosis. Results 18 cases of MPA patients accounted for 94.4% of the kidney, lung involvement accounted for 66.7%, but also involving the digestive tract, muscle and joint and nervous system. Positive MPO-ANCA was found in 94.4% of the patients, eosinophilia in 88.9% of patients, increased C-reactive protein in 77.8%, leukocytosis in 44.4% and thrombocytosis in 33.3% of patients. Hormones and cyclophosphamide as the main treatment, the induction of total remission rate was 73.3%. Conclusions The clinical manifestations of MPA are multi-organ involvement, with the most common kidney and lung involvement, and high misdiagnosis rate. The detection of AN-CA is of great importance in improving the detection rate of MPA.