62例嗜酸性肉芽肿性血管炎患者的临床特征分析  

Clinical Characterization Of 62 Patients With Eosinophilic Granulomatous Vasculitis

作　　者：陈星[1] 李晓静 李霜梅[1] 王彤[1] CHEN Xing;LI Xiao-jing;LI Shuang-mei;WANG Tong(Department of Emergency Medicine,The Eighth Affiliated Hospital of Sun Yat-sen University,Shenzhen,518033)

机构地区：[1]中山大学附属第八医院急诊科,518033

出　　处：《岭南急诊医学杂志》2024年第2期112-115,共4页Lingnan Journal of Emergency Medicine

摘　　要：目的:总结分析嗜酸性肉芽肿性血管炎(Eosinophilic granulomatous vasculitis,EGPA)患者的临床特征,为该疾病的早期诊断及治疗提供依据参考。方法:回顾性分析2008年5月至2022年4月中山大学孙逸仙纪念医院收治的62例EGPA患者的临床资料。结果:62例患者中男性61.1%,女性38.9%。29%患者以气促为首发症状,14.5%患者以咳嗽咳痰为首发症状,病程中较常见的临床表现为鼻窦炎77.4%、肢体麻木41.9%、关节痛30.6%;其他系统中神经系统受累50%,消化系统受累38.7%,心血管系统受累35.4%。胸部CT最常见表现为斑片影62.9%、结节影48.4%,病理活检方面:50%患者行组织活检,43.2%患者病理结果支持EGPA诊断。治疗上95.1%患者使用激素治疗,74.2%患者应用激素联合免疫抑制剂治疗。结论:EGPA临床表现多样且不具有特异性,病程早期累及呼吸系统常以哮喘样症状就诊于急诊科,急诊科医生应重视患者多系统的症状体征,必要时结合ANCA,肌电图、病理等手段,实现对EGPA的早诊早治。Objective:To summarize and analyze the clinical characteristics of patients with eosinophilic granulo⁃matous vasculitis(EGPA),and to provide a reference for the early diagnosis and treatment of this disease.Methods:The clinical data of 62 patients with EGPA admitted to Sun Yat⁃sen Memorial Hospital of Sun Yat⁃sen University from May 2008 to April 2022 were retrospectively analyzed.Results:Of the 62 patients,61.1%were male and 38.9%were female.29%of the patients had shortness of breath as the first symptom,14.5%had cough and sputum as the first symp⁃tom,and the more common clinical manifestations during the course of the disease were sinusitis in 77.4%of the pa⁃tients,numbness of the limbs in 41.9%of the patients,and arthralgia in 30.6%of the patients;among the other sys⁃tems,neurological involvement was found in 50%of the patients,digestive involvement in 38.7%of the patients,cardio⁃vascular involvement in 35.4%of the patients,and neurological involvement in 50%of the patients.35.4%.The most common manifestations of chest CT were patchy shadow in 62.9%and nodular shadow in 48.4%.In terms of pathological biopsy:50%of the patients underwent tissue biopsy,and 43.2%of the patientspathological results supported the diag⁃nosis of EGPA.For treatment,95.1%of patients were treated with hormone therapy,and 74.2%of patients were treated with hormone combined with immunosuppressants.Conclusion:The clinical manifestations of EGPA are complex and nonspecific,and patients with respiratory system involvement in the early stage of the disease often present to the emer⁃gency department with asthma⁃like symptoms.Emergency physicians should pay attention to the signs and symptoms of patients from multiple systems,and combine ANCA,electromyography,and pathology with other means to realize the early diagnosis and treatment of EGPA when necessary.

关 键 词：嗜酸性肉芽肿性血管炎 临床特征 急诊科 

分 类 号：R593.2[医药卫生—内科学]