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目的探讨显微镜下多血管炎(microscopic polyangiitis,MPA)临床特征和诊疗方法。方法回顾性分析5例MPA的患者。结果 5例患者,男2例,女3例,平均年龄40.5岁。发热80%(4/5),皮肤改变60%(3/5),呼吸系统症状(3/5),杵状指20%(1/5),肾脏受累包括血肌酐,血尿素氮升高100%(5/5),镜下血尿、蛋白尿80%(4/5)骨骼运动系统受损40%(2/5),眼部症状60%(3/5)。2例肾活检,P-ANCA阳性率100%(5/5),5例均使用过糖皮质激素治疗,4例有效,1例死亡。结论应重视对MPA的临床认识、诊断和治疗。P-ANCA对MPA的诊断有重要意义。激素和免疫抑制剂治疗有效,肾功能和早期治疗是影响治疗预后的关键。
Objective To investigate the clinical features and diagnosis and treatment of microscopic polyangiitis (MPA). Methods Retrospective analysis of 5 cases of MPA patients. Results 5 patients, 2 males and 3 females, with an average age of 40.5 years. 80% fever (4/5), skin changes 60% (3/5), respiratory symptoms (3/5), clubbing 20% (1/5), kidney involvement including serum creatinine, elevated blood urea nitrogen 100% (5/5), microscopic hematuria, and 80% (4/5) of proteinuria impaired the skeletal motor system by 40% (2/5) and ocular symptoms by 60% (3/5). 2 cases of renal biopsy, P-ANCA positive rate of 100% (5/5), 5 cases were treated with glucocorticoid, 4 cases were effective, 1 case died. Conclusions The clinical understanding, diagnosis and treatment of MPA should be emphasized. P-ANCA is important for the diagnosis of MPA. Hormone and immunosuppressive therapy is effective, renal function and early treatment is the key to the prognosis of treatment.