中国东南部地区某市抗中性粒细胞胞质抗体相关血管炎流行病学的回顾性调查  

A Retrospective Investigation on the Epidemiology of Anti-neutrophil Cytoplasmic Antibody-associated Vasculitis in A City, Southeast China

作　　者：张俊[1] 李弋南[1] 孙雪娟[1] 陈幸[1] 张璐 张恒远[1] 白培进 杨厦黎 黄继义[1,2] ZHANG Jun;LI Yi-nan;SUN Xue-juan;CHEN Xin;ZHANG Lu;ZHANG Heng-yuan;BAI Pei-jin;YANG Xia-li;HUANG Ji-yi(Department of Nephrology,the First Affiliated Hospital of Xiamen University,Xiamen 361003,China;The Five Hospital of Xiamen City,Tongming Branches Hospital of the First Affi liated Hospital of Xiamen University,Xiamen 361101,China)

机构地区：[1]厦门大学附属第一医院肾内科,福建厦门361003 [2]厦门市第五医院厦门大学附属第一医院同民分院,福建厦门361101

出　　处：《中国医药指南》2020年第16期1-5,共5页Guide of China Medicine

基　　金：厦门市科技局医疗卫生指导性项目(编号3502Z20189002)

摘　　要：目的对中国东南部地区厦门市抗中性粒细胞胞质抗体(ANCA)相关血管炎(AAV)的流行病学进行回顾性调查,为后续的预防诊疗提供一定的基础。方法以2012年~2017年共6年为研究期,利用本院病案室、检验科、厦门市市民健康系统对AAV病例进行筛查、确认和分类。描述本院厦门市AAV的流行病学特征,比较厦门市岛内外表型的差异。剔除外地患者,综合厦门市AAV的数据除以厦门市常住人口,估算AAV总的发病率和患病率。结果6年研究期间,本院筛查出154例AAV,进一步确认厦门市AAV48例,中位年龄60岁,男女比1∶1。临床过程中耳鼻喉受累18例(37.5%),肺损害47例(97.9%),肾损害46例(95.8%)(急进性肾炎29例(60.4%))。此48例厦门市AAV,临床分型显微镜下多血管炎(MPA)31例(64.6%),肉芽肿性多血管炎(GPA)14例(29.2%),嗜酸细胞性肉芽肿性多血管炎(EGPA)3例(6.2%);血清分型髓过氧化物酶(MPO)-AAV38例(79.2%),蛋白酶3(PR3)-AAV 9例(18.7%),ANCA阴性1例(2.1%)。统计分析显示厦门市岛内外不同地理环境临床分型差异明显,而血清分型无差异。厦门市市民健康系统整理其他医院厦门市AAV病例共64例,综合发病和患病数据,计算AAV发病率平均4.4例/百万人群/年;期间患病率平均13.87例/百万人群/年。结论中国东南部地区厦门市AAV以MPA和MPO-AAV为主,与之前报道的亚洲人群AAV特征相符。城市化不同的岛内外地理环境可能影响AAV临床表型,但不影响血清型。还首次估算了国内确定地区AAV总的发病率(4.4例/百万人群/年)和患病率(13.87例/百万人群/年),均低于其他国家报道的数据。Objective To conduct a retrospective investigation of the epidemiological status of AAV in Xiamen City,southeast China,and to provide a foundation for subsequent prevention,diagnosis and treatment.Methods A total of 6 years from 2012 to 2017 was used as the study period.AAV cases were screened,identified and classified using our hospital medical records,laboratory,and Xiamen citizen health system.To describe the epidemiological characteristics of AAV of our hospital in Xiamen,and to compare the difference of phenotypes between different geographical environments of Xiamen.Excluding the field patients,combined with the data of AAV in Xiamen from our hospital and other hospitals,the total incidence and prevalence of AAV were estimated by dividing by the resident population of Xiamen city.Results During the six-year study period,154 AAV cases were screened in our hospital and 48 AAV cases in Xiamen were further identified.The median age was 60 years old and the ratio of males to females was 1∶1.In the clinical course,there were 18 cases(37.5%)suffered from otorhinolaryngologic diseases,47 cases(97.9%)suffered from lung damage,46 cases(95.8%)suffered from kidney damage(29 cases(60.4%)of rapidly progressive glomerulonephritis).48 cases of AAV in Xiamen City were divided into 31 cases of MPA(64.6%),14 cases of GPA(29.2%)and 3 cases of EGPA(6.2%)based on clinical phenotype,or classified 38 cases of MPO-AAV(79.2%),9 cases of PR3-AAV(18.7%)and 1 case of ANCA negative AAV(2.1%)according to ANCA specificity.Statistical analysis showed that there is significant difference in clinical phenotype between inside and outside the island,but no difference in ANCA specificity between different geographical environments.A total of 64 AAV cases in other hospitals in Xiamen were sorted out by Xiamen citizen health system.The comprehensive incidence and prevalence data were calculated.The average incidence of AAV was 4.4 cases per million population-year,and the average prevalence was 13.87 cases per million population-year.Conclusion

关 键 词：抗中性粒细胞胞质抗体相关血管炎 流行病学 发病率 患病率 

分 类 号：R543[医药卫生—心血管疾病]