抗中性粒细胞胞浆抗体在ANCA相关血管炎患者中的临床意义  

Effect of anti-neutrophil cytoplasmic antibodies on ANCA associated vasculitis

作　　者：张贝 高子宇 李鑫 雷易萌 夏丽萍[1] 鲁静[1] 沈晖[1] ZHANG Bei;GAO Zi-yu;LI Xin;LEI Yi-meng;XIA Li-ping;LU Jing;SHEN Hui(Department of Rheumatology,the Firsl Affiliated Hospital of China Medical University,Liaoning Shenyang 110001.China;Class86,104k,China Medical University,Liaoning Shenyang 110001,China;Department of Rheumatology,1st Affiliated Hospital of Jinzhou Medical University,Jinzhou 121000,China)

机构地区：[1]中国医科大学附属第一医院风湿免疫科,辽宁沈阳110001 [2]中国医科大学,辽宁沈阳110001 [3]锦州医科大学附属第一医院风湿免疫科,辽宁锦州121000

出　　处：《解剖科学进展》2020年第1期14-17,共4页Progress of Anatomical Sciences

基　　金：国家自然科学基金(81373219);辽宁省教育厅科学基金(JC2019009)。

摘　　要：目的抗中性粒细胞胞浆抗体(anti-neutrophil cytoplasmic antibody,ANCA)两种类型,核周型(p-ANCA)及胞浆型(c-ANCA),比较p-ANCA阳性与c-ANCA阳性的ANCA相关血管炎(ANCA-associated vasculitis,AAV)患者临床特征、实验室指标及器官受累的差异。方法选取50例AAV患者,血清ANCA的检测采用间接免疫荧光法。根据ANCA血清分型分为p-ANCA阳性组与c-ANCA阳性组,同时检测两组患者血生化、尿常规、炎症指标、免疫指标;高分辨CT(high resolution CT,HRCT)评估AAV患者肺脏受累情况;AAV患者疾病活动度采用疾病累及范围指数(disease extent index,DEI)评分。结果 p-ANCA阳性组患者易伴发红细胞减少及肺间质疾病;c-ANCA阳性的患者年龄更小,病程更短,更易伴发镜下血尿、听力下降、鼻窦炎。两组的DEI评分无显著差异。结论 c-ANCA阳性患者临床表现重于p-ANCA阳性组患者,器官受累更重,预后更差。Objective Anti-neutrophil cytoplasmic antibodies(ANCA) were divided into perinuclear ANCA(pANCA) and cytoplasmic ANCA(c-ANCA). To compare the clinical characteristics, laboratory indexes and organ involvement in patients with p-ANCA positive and c-ANCA positive ANCA associated vasculitis(AAV). Methods 50 patients with AAV were divided into p-ANCA positive group and c-ANCA positive group. Blood biochemistry, urine routine, inflammatory index and immune index were detected in the two groups. High resolution CT(HRCT) was used to detect lung involvement in patients with AAV. Disease activity was evaluated by disease extent index(DEI). Results p-ANCA positive patients were prone to erythrocytopenia and pulmonary interstitial diseases, c-ANCN positive patients were younger, shorter course of disease, more likely to be accompanied by microscopic hematuria, hearing loss, sinusitis. There was no significant difference in DEI between the two groups. Conclusion The clinical manifestations of c-ANCA positive patients were more serious than those of p-ANCA positive patients, with more serious organ involvement and worse prognosis.

关 键 词：P-ANCA C-ANCA ANCA相关性血管炎 疾病累及范围指数 

分 类 号：R543[医药卫生—心血管疾病]