原发性小血管炎肺脏受累  

Lung involvement of patients with ANCA-related vasculitis

作　　者：姜筠[1] 赵明辉[1] 章友康[1] 刘玉春[1] 王海燕[1] 

机构地区：[1]北京医科大学第一医院肾内科,100034

出　　处：《中华肾脏病杂志》1999年第5期291-294,共4页Chinese Journal of Nephrology

摘　　要：目的　探讨原发性小血管炎肺脏受累的诊断和治疗。方法　对 15例原发性小血管炎伴肺脏受累患者的临床资料进行分析。结果　肺脏是原发性小血管炎常受累脏器之一 ,约占原发性小血管炎患者 6 0 % (15 / 2 5例 )。肺脏受累的临床表现有咳嗽、哮喘 ,不同程度咯血 ,胸片呈现多样化。由于肺泡广泛出血导致大咯血窒息及严重低氧血症是肺脏受累的严重并发症 ,若能及时采用血浆置换疗法和 (或 )激素、细胞毒冲击治疗 ,肺出血可迅速吸收。动态观察发现不少病人胸片及临床症状可呈戏剧性变化 ,临床危重症得以改善。结论　原发性小血管炎伴肺脏受累是常见的。适当的治疗可改善其预后。Objective To investigate the pulmonary manifestations of patients with ANCA related vasculitis.Methods Clinical data from 15 patients with ANCA related vasculitis were collected and their pulmonary manifestations were further analyzed.Results 60% of the 25 patients had lung involvement.They had cough,asthma and hemoptysis.Findings on lung X ray films were variable.Heavy pulmonary hemorrhage and hypoxemia due to extensive pulmonary capillary bleeding were the most severe conditions for those patients.Pulmonary hemorrhage could be absorbed quickly and clinical condition could improve dramatically by intensive plasma exchange accompanied with immunosuppressive therapy.Couclusion Lung involvement,with variable forms,is common in patients with ANCA related vasculitis.Appropriate treatment is necessary to get better prognosis for these patients.

关 键 词：小血管炎 原发性 肺出血 血浆置换 诊断 治疗 

分 类 号：R543[医药卫生—心血管疾病] R563.6[医药卫生—内科学]