坏死性肉芽肿血管炎下呼吸道损害3例病例分析及文献回顾  

Analysis of 3 cases necrotizing granulomatous vasculitis with lower respiratory tract damage

作　　者：罗旭明[1] 杨炜[1] 唐继红[1] 王雄彪[1] 

机构地区：[1]上海中医药大学附属普陀医院呼吸内科,上海200062

出　　处：《世界临床药物》2010年第2期98-101,110,共5页World Clinical Drug

摘　　要：目的分析坏死性肉芽肿血管炎(NGV)的临床漏诊和误诊情况,探讨临床相关诊治方案。方法本文以临床3例误诊病例为例,结合文献资料,分析探讨NGV病例下呼吸道临床表现,并从呼吸内科的角度重点分析现有方法对NGV诊断的有效性以及药物治疗的疗效。结果反复未愈的3例病例经肺功能检测结合胸部CT检查或支气管镜检查考虑为NGV,接受泼尼松治疗症状缓解。结论综合考虑胸部放射性检查、肺功能检测和支气管镜检查结果可明确NGV诊断,同时临床应重视NGV的早期诊断,并及时对症治疗。Objective To analyze misdiagnosis and missed diagnosis of necrotizing granulomatous vascuritis （NGV, also called Wegener granulomatosis） and to explore methods of clinical diagnosis and treatment. Methods Clinical manifestations of lower respiratory tract in 3 misdiagnosed cases of NGV were analyzed. From the perspective of respiratory medicine, the efficiency of NGV diagnosis and treatment was evaluated. Results The uncured cases after treatment in the respiratory department were diagnosed as NGV after pulmonary fuction testing with chest CT or bronchoscope. They were cured by oral administration of 40 mg prednisome. Conclusion Chest radiological examination, pulmonary function test and bronchoscope are all necessary for diagnosis of NGV. More attention should be paid to its early diagnosis and symptomatic treatment.

关 键 词：坏死性肉芽肿血管炎 下呼吸道 早期诊断 

分 类 号：R593.2[医药卫生—内科学] R441[医药卫生—临床医学]