ANCA相关血管炎临床及胸部CT表现  

Clinical manifestations and chest CT images of antineutrophil cytoplasmic antibodies associated vasculitis

作　　者：郑慧 李建玉 蔡伟国 张寒菲 陈杰[1] 廖美焱[1] ZHENG Hui;LI Jianyu;CAI Weiguo;ZHANG Hanfei;CHEN Jie;LIAO Meiyan(Dept,of Radiology,Zhongnan Hospital of Wuhan University,Wuhan 430071,Hubei.China)

机构地区：[1]武汉大学中南医院影像科,湖北武汉430071

出　　处：《武汉大学学报（医学版）》2021年第1期142-146,共5页Medical Journal of Wuhan University

摘　　要：目的:探讨不同血清亚型抗中性粒细胞胞浆抗体(ANCA)相关血管炎(AAV)临床及胸部CT表现。方法:回顾性分析2012年至2018年本院诊断为AAV的病例资料,分为胞浆型(c-ANCA)和核周型(p-ANCA)两组,比较两组病例临床及胸部CT表现的差异性。结果:69名病例中肾脏损伤64例、其中肾衰竭21例;咳嗽、咳痰35例;恶心、呕吐等胃肠道表现26例。59例胸部CT中表现为肺磨玻璃密度影31例,纤维化改变16例,c-ANCA组双肺多发结节比例高于p-ANCA组(P<0.05)。p-ANCA组血沉高于c-ANCA组(P<0.05)。结论:AAV是多系统受累的一类疾病,肾脏损伤最为常见,ANCA血清学检测为主要诊断依据,CT影像主要以肺磨玻璃样密度、纤维化改变及结节/肿块为主,c-ANCA型比p-ANCA型影像学表现更具特异性;影像学可以监测治疗效果。Objective:To investigate the imaging and clinical features of antineutrophil cytoplasmic antibodies(ANCA) associated vasculitis(AAV) in different serum subtypes.Methods:The data of AAV cases diagnosed from 2012 to 2018 were analyzed retrospectively.The patients were divided into two groups as cytoplasmic ANCA(c-ANCA) group and perinuclear ANCA(p-ANCA) group.The clinical and chest CT findings of the two groups were compared.Results:Of the 69 AAV cases included,64 cases showed renal function insufficiency,including 21 cases of renal failure;35 patients had coughs;26 aptients showed gastrointestinal manifestations such as nausea and vomiting.By chest CT scanning,there were 31 cases showed ground glass density and 16 cases with pulmonary fibrosis.cANCA group was more likely to show multiple nodules on CT images(P<0.05).The erythrocyte sedimentation rate(ESR) in c-ANCA group was significantly higher than that in p-ANCA group.Conclusion:AAV is a multi-system involved disease.ANCA serological detection plays a very important role in the diagnosis of the disease,and the imaging findings of c-ANCA patients are more specific in the two subtypes.

关 键 词：抗中性粒细胞胞浆抗体 血管炎 胸部CT 

分 类 号：R593.2[医药卫生—内科学] R816.4[医药卫生—放射医学]