标题：清远地区ANCA相关性血管炎61例临床分析

      作者：尚榆淇，魏建波，卢勤燕，吴传聪，彭翔    广州医科大学附属第六医院清远市人民医院肾内科，广东 清远 511518

      卷次： 2019年30卷1期

      【摘要】 目的 分析清远地区抗中性粒细胞胞浆抗体(ANCA)相关性血管炎患者多系统受累的临床表现。方法 回顾性分析2002年1月至2017年6月清远市人民医院肾内科确诊为ANCA相关性血管炎的61例患者的临床资料。结果 胞浆型 ANCA (cANCA)阳性 5例，核周型 ANCA (pANCA)阳性 48例，抗髓过氧化物酶抗体(MPO-Ab)阳性 51例，抗蛋白酶 3抗体(PR3-Ab)阳性 10例；其中 cANCA合并 PR3-Ab阳性 2例，pANCA合并MPO-Ab阳性 42例；pANCA合并PR3-Ab阳性 6例(其中合并抗核抗体阳性 4例)，cANCA合并MPO-Ab阳性 3例(其中合并抗核抗体阳性1例)。该病临床表现复杂多样，目前主要采用激素联合免疫抑制剂方案治疗，但患者接受程度及依从性较差，大部分已进入肾衰竭期并行肾脏替代治疗。结论 ANCA相关性血管炎在清远地区并非不常见，临床上表现为多系统受累患者，需警惕ANCA相关性血管炎可能，推广ANCA检测有助于提高早期诊断率。
      【关键词】 清远地区；抗中性粒细胞胞浆抗体；血管炎；临床分析
      【中图分类号】 R543 【文献标识码】 A 【文章编号】 1003—6350（2019）01—0041—04

Clinical manifestations in 61 patients with anti-neutrophil cytoplasmic autoanfibodies related vasculitis inQingyuan area.
SHANG Yu-qi, WEI Jian-bo, LU Qin-yan, WU Chuan-cong, PENG Xiang. Department of Nephropathy,the Sixth Affiliated Hospital of Guangzhou Medical University (Qingyuan People's Hospital), Qingyuan 511518, Guangdong,CHINA
【Abstract】 Objective To analyze the clinical manifestations of multi-system involvement in 61 patients withanti-neutrophil cytoplasmic autoanfibodies (ANCA) related vasculitis in Qingyuan area. Methods The clinical datas of61 patients with ANCA related vasculitis diagnosed in Department of Nephropathy, Qingyuan People's Hospital fromJanuary 2002 to June 2017 were retrospectively analyzed. Results There were 5 cases of cytoplasmic ANCA (cANCA)positive, 48 cases of perinuclear ANCA (pANCA) positive, 51 cases of anti-myeloperoxidase antibodies (MPO-Ab) posi-tive, 10 cases of anti-proteinase 3 antibody (PR3-Ab) positive, among which there were 2 cases positive for both cAN-CA and PR3-Ab, 42 cases positive for both pANCA and MPO-Ab, 6 cases positive for both pANCA and PR3-Ab (ofwhich 4 cases were positive for antinuclear antibody), 3 cases positive for cANCA combined with MPO-Ab (of which 1case was positive for antinuclear antibody). The clinical manifestations of the disease are complex. Currently the maintreatment for the disease is glucocorticoid and immunosuppressive medicine, but the patients' acceptance and compli-ance are poor. Most of the patients have entered the stage of renal failure and have been treated with renal replacementtherapy. Conclusion ANCA related vasculitis is common in Qingyuan area, and its clinical manifestation is multi-sys-tem involvement. It is necessary to be alert to the possibility of ANCA related vasculitis, and popularizing ANCA detec-tion is helpful to improve the early diagnosis rate.
      【Key words】 Qingyuan area; Anti-neutrophil cytoplasmic autoantibodies (ANCA); Vasculitis; Clinical analysis