对嗜酸性肉芽肿性多血管炎临床诊断与治疗的思考  

Clinical challenges in the diagnosis and treatment of eosinophilic granulomatosis with polyangiits

作　　者：施举红[1] SHI Juhong(Department of Pulmonary and Critical Care Medicine,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences&Peking Union Medical College,Beijing 100730,China)

机构地区：[1]中国医学科学院北京协和医学院北京协和医院呼吸与危重症医学科,北京100730

出　　处：《中华临床免疫和变态反应杂志》2024年第2期105-109,共5页Chinese Journal of Allergy & Clinical Immunology

基　　金：国家重点研发计划常见多发病防治研究(2023YFC2507204);中央高水平医院临床科研业务费(2022-PUMCH-C-017)。

摘　　要：嗜酸性肉芽肿性多血管炎(eosinophilic granulomatosis with polyangiits,EGPA)主要特征为嗜酸性粒细胞增多、肉芽肿形成、中小血管坏死性血管炎。EGPA患者因嗜酸性粒细胞浸润、嗜酸性粒细胞诱导的纤维化和高凝状态导致器官损伤,同时伴过敏表现。本文围绕EGPA的发病机制、临床表现、分类标准变迁及治疗进展进行阐述,并对其诊断及治疗面临的临床困境提出建议与思考。Eosinophilic granulomatosis with polyangiitis(EGPA)is characterized by an increase in eosinophils,the formation of granulomas,and necrotizing vasculitis in small to medium-sized blood vessels.EGPA patients experience organ damage due to infiltration of eosinophils,fibrosis induced by eosinophils,and a hypercoagulable state,accompanied by allergic manifestations.This article provides a comprehensive review of the pathogenesis,clinical presentation,changes in classification criteria,and advances in treatment for EGPA.Additionally,suggestions and considerations are proposed regarding the clinical challenges in diagnosing and treating EGPA.

关 键 词：血管炎 嗜酸细胞增多 生物制剂 

分 类 号：R593.2[医药卫生—内科学]