嗜酸性肉芽肿性血管炎的临床及胸部高分辨率CT表现特点分析  

Eosinophilic granulomatosis with polyangiitis: analysis by combining with clinical presentations and high resolution computed tomography features

作　　者：张耀允 余建群[1] Zhang Yaoyun;Yu Jianqun(Department of Radiology,West China Hospital of Sichuan University,Chengdu 610041,China)

机构地区：[1]四川大学华西医院放射科,成都610041

出　　处：《中华风湿病学杂志》2021年第1期50-53,共4页Chinese Journal of Rheumatology

摘　　要：目的探讨嗜酸性肉芽肿性血管炎(EGPA)患者的临床及胸部高分辨率CT(HRCT)影像征象,为临床诊断及治疗决策提供有效帮助。方法回顾性分析15例临床确诊的EGPA患者的临床资料、相关实验室数据、HRCT征象、治疗及预后,应用SPSS 21.0软件对数据进行统计分析。结果15例患者中,男性8例,女性7例,中位年龄48岁;首次误诊为难治性哮喘的4例(27%)。最常见临床表现为副鼻窦炎症14例(93%),其次为咳嗽喘息13例(87%)。实验室检查中嗜酸粒细胞增多13例(87%),抗中性粒细胞胞质抗体(ANCA)阳性者5例(39%)。常见胸部HRCT征象为:纤维条索影13例(87%)、磨玻璃斑片影12例(80%)、小叶间隔增厚10例(67%)及小结节9例(60%)。应用五因素评分体系(FFS)进行评分,FFS为0分5例(33%)、1分6例(40%),最后共12例(80%)患者治疗缓解后出院。结论EGPA发病率低,临床表现及胸部HRCT征象不具特征性,结合副鼻窦检查、肌电图、实验室等综合检查结果,有助于EGPA诊断正确率的提高。Objective To observe and analysis the clinical presentations and high resolution computed tomography(HRCT)features of patients with eosinophilic granulomatosis with polyangiitis(EGPA),and to provide support for clinical diagnosis and treatment decision.Methods Clinical characteristics,relevant laboratory data,HRCT features,treatment and prognosis of 15 clinically confirmed EGPA patients were analyzed retrospectively.Statistical Program for Social Sciences(SPSS)21.0 software was used for statistical analysis of the data.Results Among the 15 patients,there were 8 males and 7 females,with a midian age of 48.Four cases(27%)were misdiagnosed as refractory asthma for the first time.The most common clinical manifestation was paranasal sinus inflammation in 14 cases(93%),followed by cough and wheeze in 13 cases(87%).In the laboratory examination,eosinophilia was found in 13 cases(87%)and ANCA positive in 5 cases(39%).The common chest HRCT signs were:fiber stripes in 13 cases(87%),patch ground glass opacities in 12 cases(80%),interlobular septal thickening in 10 cases(67%),and nodules in 9 cases(60%).The five-factor score(FFS)was used to score the patients,and FFS were 5(33%)with score 0 and 6(40%)with score1.Finally,12 patients(80%)were discharged after remission.Conclusion The EGPA has a low incidence and no spefic clinical manifestations and chest HRCT features,so it hasto be diagnosed by combination of paranasal sinus examination,electromyography and laboratory tests.

关 键 词：血管炎 变应性肉芽肿性 体征和症状 体层摄影术 螺旋计算机 

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