变应性肉芽肿性血管炎的临床及病理学特点(附4例报告)  

Clinical and pathological characteristics of allergic granulomatous angiitis

作　　者：康智敏[1] 赵伟秦[1] 李继梅[1] 毕鸿雁[1] 

机构地区：[1]首都医科大学附属北京友谊医院神经内科,100050

出　　处：《北京医学》2010年第8期660-662,共3页Beijing Medical Journal

摘　　要：目的分析变应性肉芽肿性血管炎(Churg-Strauss综合征,CSS)的临床及病理学特点,提高诊断水平。方法复习确诊为CSS的4例患者的住院资料,对其临床表现及病理学特点进行总结。结果本病临床表现多种多样,以呼吸系统和周围神经受累最常见,所有患者末梢血的嗜酸性粒细胞比例增高(27.5%～73.3%)。3例肌肉活检显示血管炎性改变及嗜酸性粒细胞浸润;1例腓肠神经活检可见神经束内有髓纤维轴索变性,神经外膜血管炎性病变伴嗜酸粒细胞浸润。结论当患者出现呼吸系统和周围神经等多系统受累表现及末梢血嗜酸粒细胞比例增高时,应进行相关组织病理检查,及时诊断治疗。Objective To analyze the clinical manifestations and the pathological characteristics of allergic granulomatous angiitis（CSS） in order to increase the level of diagnosis.Methods The hospitalization data of four patients diagnosed as Churg-Strauss syndrome was reviewed,especially the clinical manifestations and the pathological features.Results The clinical pictures of allergic granulomatous angiitis varied.The respiratory system and peripheral nerves were the most frequently involved.The percentage of peripheral blood eosinophil cells was significant increased in all cases （between 27.5% to 73.3%）.Muscle biopsy of three patients showed inflammatory changes in blood vessels and infiltration of eosinophile granulocytes.Sural nerve biopsy demonstrated axonal degeneration of myelinated fiber within nerve tracts,vasculitic lesions and eosinophilic cell infiltrating in epineurial vessel.Conclusions Biopsy should be performed in order to make diagnose and start appropriate treatment for patients promptly when symptoms of respiratory tract, peripheral nerves and other organs accompanied with increase of eosinophil cells present.

关 键 词：变应性肉芽肿性血管炎 CHURG-STRAUSS综合征 血管炎性神经病 活组织检查 

分 类 号：R593[医药卫生—内科学]