心脏受累的ANCA相关性血管炎研究进展  

Research progress of ANCA-associated vasculitis with cardiac involvement

作　　者：李乃荣 龙安雄(综述) 马顺高(审校) LI Nai-rong;LONG An-xiong;MAShun-gao(Clinical College,Dali University,Dali 671000,Yunnan,CHINA;People's Hospital of Dali Bai Autonomous Prefecture,Dali 671000,Yunnan,CHINA)

机构地区：[1]大理大学临床医学院,云南大理671000 [2]云南省大理白族自治州人民医院,云南大理671000

出　　处：《海南医学》2021年第21期2804-2807,共4页Hainan Medical Journal

摘　　要：抗中性粒细胞胞浆抗体(ANCA)相关性血管炎(AAV)是一种罕见且严重的中小血管炎症性疾病。2012年Chanpel Hill研究将其分为肉芽肿性多血管炎(GPA)、显微镜下多血管炎(MPA)和嗜酸性肉芽肿性血管炎(EGPA)三种亚型。这三种类型的AAV均可引起心脏受累,常表现为心包炎、心肌炎、心脏瓣膜病变、冠状动脉血管炎炎以及心脏电传导系统异常等。而合并心脏受累的患者预后普遍较差。临床上AAV患者明显心脏受损的症状少见,亚临床心脏受累可能被诊断不足且未得到充分治疗,这显著增加了患者的死亡风险。基于ANCA相关性血管炎心脏受累的临床现状及严重的不良预后,本文将综述该领域报道的最新进展,以提高临床医师对AAV心脏受累的重视。Antineutrophil cytoplasmic antibody(ANCA)-associated vasculitis(AAV)is a rare and serious inflammatory disease of small and medium blood vessels.The 2012 International Chapel Hill Consensus Conference classified it into granulomatosis with polyangiitis(Wegener's,GPA),microscopic polyangiitis(MPA),and eosinophilic granulomatosis with polyangiitis(Churg-Strauss,EGPA).These three types of AAV can cause heart involvement,often manifested as pericarditis,myocarditis,heart valve disease,coronary vasculitis,and abnormalities in the electrical conduction system of the heart.The prognosis of patients with heart involvement is generally poor.Clinically,the symptoms of obvious cardiac damage in AAV patients are rare,and subclinical cardiac involvement may be underdiagnosed and undertreated,which significantly increases the patient's risk of death.Based on the clinical status of ANCA-associated vasculitis and the serious adverse prognosis,this article will review the latest developments reported in this field in order to increase the attention of clinicians to AAV cardiac involvement.

关 键 词：ANCA相关性血管炎 流行病学 心血管疾病 临床特点 治疗 

分 类 号：R543[医药卫生—心血管疾病]