嗜酸性肉芽肿性血管炎患者的临床特征分析  

The clinical manifestation and analysis of eosinophilic granulomatous vasculitis

作　　者：苏凡[1] 邱茜[1] 蔡冬梅[1] 梁柳琴[1] 杨岫岩[1] 

机构地区：[1]中山大学附属第一医院风湿内科,广州510080

出　　处：《中华医学杂志》2016年第27期2142-2145,共4页National Medical Journal of China

摘　　要：目的探讨嗜酸性肉芽肿性血管炎患者的临床特征、治疗和预后。方法分析2005至2014年中山大学附属第一医院风湿免疫科诊断和治疗随访的43例嗜酸性肉芽肿性血管炎患者，总结临床与实验室特征、治疗与转归。结果在43例中31例（72．1％）在既往史、现病史和体检中存在变应性症状，其中有哮喘症状或听诊肺部哮鸣音者16例（37．2％）。组织和脏器受累包括皮肤、肢端、肺脏、肾脏、中枢和周围神经系统、消化系统、心脏等。中性粒细胞胞质抗体（ANCA）阳性18例（41．9％），以MPO—ANCA阳性为主。血嗜酸性粒细胞增高者39例（90．7％），43例（100％）均有血IgE增高。2例在急性期死于多脏器衰竭，其余41例经用激素和环磷酰胺或甲氨蝶呤治疗，预后良好。结论嗜酸性肉芽肿性血管炎可以损害各个脏器和组织；仅72．1％的患者存在变应性症状，只有37．2％的患者存在哮喘或肺部哮鸣音；超半数的患者ANCA阴性；激素联合环磷酰胺或甲氨蝶呤治疗可取得较好的疗效。Objective To evaluate the clinical features, treatment and prognosis of Eosinophilic Granulomatous Vasculitis. Methods We analyzed retrospectively the clinical and laboratory features, treatment and prognosis of 43 patients with Eosinophilic Granulomatous Vasculitis who admitted to the Department of Rheumatology of the First Affiliated University Hospital of Sun Yat-sen University between 2005 and 2014. Results Of the 43 patients, 31 patients （72. 1% ） had allergic symptoms in the disease course and 16 patients （37. 2% ） had asthma and lung wheezing sound when performing the physical examination. Organs involvements included skin, acra, lung, kidney, central and peripheral nervous system, digestive system and heart. Positive antineutrophilic cytoplasmic antibody （ANCA） which mainly with MPO- ANCA was found in 18 patients （41.9%）. Thirty-nine patients （90. 7% ） had high blood eosinophil level while all patients （ 100% ） had elevated IgE. Two patients died of multiple organ failure in their acute phase, and the others had favorable prognosis after receiving the treatment of glucocorticoid combine with cyclophosphamide or methotrexate. Conclusions Eosinophilic Granulomatous Vasculitiscould make damage to organs and tissues. Only 72. 1% patients had allergic symptoms and 37.2% patients had asthma and lung wheezing sound. More than half patients have the negative ANCA. Glucocorticoidcombine with cyclophosphamide or methotrexate can achieve satisfactory therapeutic effects.

关 键 词：嗜酸性肉芽肿性血管炎 变应性肉芽肿性血管炎 CHURG-STRAUSS综合征 临床特征 

分 类 号：R593.2[医药卫生—内科学]