韦格纳氏肉芽肿治疗最新进展  

The latest developments in the treatment of Wegener's granulomatosis

作　　者：尤丕聪[1] 刘洋[1] 王永明[1] 贾洪艳[1] 王维秀[1] 武子霞[1] 由希雷[1] 

机构地区：[1]天津市天和医院,天津300050

出　　处：《中国现代医学杂志》2009年第11期1676-1679,共4页China Journal of Modern Medicine

摘　　要：韦格氏肉芽肿(WG)是一种病因不明的系统性疾病。临床特征是坏死性炎性肉芽肿,组织坏死,不同程度的中小血管病变。临床表现涉及上呼吸道、肺脏及肾脏病变。WG的诊断依据临床表现和实验室检查。如果患者出现典型的三联症上呼吸道症状、肺部症状和肾脏症状且ANCA阳性,不需要活检就能确诊。在最近几年,韦格内肉芽肿的治疗出现了一种降低剂量综合措施的新标准。通过两个阶段的治疗达到这些目标:诱导缓解阶段,及随后的维持缓解阶段。在诱导阶段,目前短疗程联合应用糖皮质激素和环磷酰胺。在诱导病情缓解成功后,治疗的核心转向维持阶段即糖皮质激素减量期。Wegener＇s granulomatosis （WG） is a systematic disease of unknown etiology. The clinical features of WG are necrotizing granulomatous inflammation, necrosis and the varying levels of medium-sized and small vascular lesions. The clinical manifestations involved of respiratory tract disease, lung and kidney lesions. WG diagnosis based on clinical and laboratory examinations. If patient with typical triple （upper respiratory, lung and kidney symptoms） and antieutrophil cytoplasmic antibody （ANCA） positive, it can be diagnosed as WG without biopsy. In recently years, there has been a new standard of WG treatment of low dose comprehensive measures. The treatment through two stages of treatment to achieve these goals： remission induction phase, and the subsequent maintenance of remission stage. In the remission induction phase, there is the joint application of glueoeortieoids and eyclophosphamide for a short eouse of treatment. After successful illness, the core of WG treatment transferred to the maintain of remission stage to reduce the dosage of glucocorticoid.

关 键 词：韦格氏肉芽肿 抗中性粒细胞胞浆抗体(ANCA) 血管炎 治疗进展 

分 类 号：R543[医药卫生—心血管疾病] R725.163[医药卫生—内科学]