血管炎的分类及ICD-10编码探讨  

Classification and ICD-10 coding of vasculitis

作　　者：卢彦冰 LU Yanbing(The First Affiliated Hospital,Sun Yat-sen University,Guangzhou 510080,China)

机构地区：[1]中山大学附属第一医院,广东广州510080

出　　处：《现代医院》2022年第6期884-886,889,共4页Modern Hospitals

摘　　要：目的归纳血管炎各种类型的ICD-10编码,提高血管炎编码准确性。方法以2012年CHCC共识为标准,总结血管炎的分类和编码,并予以案例分析。结果大血管炎包括多发性大动脉炎(M31.4)和巨细胞动脉炎(M31.5);中血管炎包括结节性多动脉炎(M30.0)和川崎病(M30.3);小血管炎分为ANCA相关和免疫复合物相关性血管炎,前者包括显微镜下多血管炎(M31.7)、肉芽肿性多血管炎(M31.3)和嗜酸性肉芽肿性多血管炎(M30.1),后者包括抗肾小球基底膜抗体病(M31.0)、IgA相关性血管炎(D69.0)、冷球蛋白血症性血管炎(D89.1)和低补体荨麻疹性血管炎(L95.9);变应性血管炎包括贝赫切特病(M35.2)和科根综合征(H16.3);单器官血管炎包括原发性中枢神经系统血管炎(I67.7)和皮肤白细胞破碎性血管炎(L95.9)。结论对血管炎进行编码时,需掌握该疾病的分类原则,注意病名别称,并紧跟临床进展。Objective To summarize the ICD-10 coding of various kinds of vasculitis and improve the accuracy of vasculitis coding.Methods The classification and coding of vasculitis was summarized based on the 2012 CHCC consensus and illustrated with case studies.Results Large vessel vasculitis(LVV)was classified to include Akayasu arteritis(M31.4)and Giant cell arteritis(M31.5),medium vessel vasculitis(MVV)to include Polyarteritis nodosa(M30.0)and Kawasaki disease(M30.3),small vessel vasculitis(SVV)to include ANCA-associated and immune complex-associated vasculitis,the former sub-classified to include microscopic polyvasculitis(M31.7)granulomatosis with polyangiitis(M31.3),and eosinophilic granulomatous polyvasculitis(M30.1),and the latter to include anti-glomerular basal membrane antibody disease(M31.0),IgA-associated vasculitis(D69.0),Cryoglobulinemic vasculitis(D89.1),and Hypocomplement urticaria vasculitis(L95.9);allergic vessel vasculitis(AVV)to include Behcet’s disease(M35.2)and Cogan syndrome(H16.3)and finally single-organ vasculitis(SOV)to include primary angiitis of the central nervous system(I67.7)and cutaneous leucocytoclastic vasculitis(L95.9).Conclusion To code vasculitis,we should have fundamental knowledge of their classification standards,pay attention to the multiple nicknames,and track the clinical research progress.

关 键 词：大血管炎 中血管炎 小血管炎 变应性血管炎 单器官血管炎 

分 类 号：R197.323[医药卫生—卫生事业管理] R543[医药卫生—公共卫生与预防医学]