韦格纳肉芽肿肺损害的临床及影像学分析  

Clinical data analysis and chest radiographic features of Wegener's granulomatosis with pulmonary involvement

作　　者：康春燕[1] 刘长庭[1] 王雅娟[1] 李天志[1] 

机构地区：[1]中国人民解放军总医院南楼呼吸科,北京100853

出　　处：《南方医科大学学报》2010年第4期786-788,共3页Journal of Southern Medical University

基　　金：军队医药卫生十一五计划专项滚动课题(06Z048)

摘　　要：目的通过分析韦格纳肉芽肿肺损害的临床及影像资料,加强对该病的认识,提高诊断的准确性。方法对43例确诊有肺损害的韦格纳肉芽肿患者的临床及影像学资料进行回顾性分析。结果临床表现多为多器官受累,肺部受侵犯几率为72.8%,症状主要为咳嗽、咳痰、咯血、呼吸困难等。肺部影像学表现病变多样,结节和空洞是最常见表现,亦可呈片状侵润及支气管狭窄改变,易被误诊。结论韦格纳肉芽肿可累及多系统、多器官,肺是最易侵犯的器官之一,但肺临床症状及胸部影像均无特异性表现,容易误诊。组织活检和ANCA检查是明确诊断的重要方法。Objective To improve the diagnostic accuracy of Wegener＇s granulomatosis （WG） with pulmonary involvement by analyzing the clinical data and chest radiographic features.Methods The clinical data and chest radiographic features of 43 WG cases with pulmonary involvement were retrospectively analyzed.Results Clinically,the patients frequently presented with multi-system involvement,with the incidence of pulmonary involvement of 72.8%.The patients with WG presented with such symptoms in the respiratory system as coughing,expectoration,hemoptysis,and dyspnea.The radiographic manifestations varied among the cases.Nodules and cavitations in the lungs were the signs most frequently found,and patchy infiltration and bronchial narrowing were also observed,which often led to misdiagnosis of WG as other pulmonary diseases.Conclusion WG often has multi-organ involvement,and the lung is one of the most commonly involved organs.The clinical symptoms and radiographic manifestations of WG have no specificity,and the disease can be easily misdiagnosed.Biopsy and ANCA assay can be important means for WG diagnosis.

关 键 词：韦格纳肉芽肿 胸部影像 抗中性粒细胞浆抗体 

分 类 号：R593.9[医药卫生—内科学]