标题：心脏受累的ANCA相关性血管炎研究进展

      作者：李乃荣 1，龙安雄 2 综述 马顺高 2 审校    1.大理大学临床医学院，云南 大理 671000；2.云南省大理白族自治州人民医院，云南 大理 671000

      卷次： 2021年32卷21期

      【摘要】 抗中性粒细胞胞浆抗体(ANCA)相关性血管炎(AAV)是一种罕见且严重的中小血管炎症性疾病。2012年Chanpel Hill研究将其分为肉芽肿性多血管炎(GPA)、显微镜下多血管炎(MPA)和嗜酸性肉芽肿性血管炎(EGPA)三种亚型。这三种类型的AAV均可引起心脏受累，常表现为心包炎、心肌炎、心脏瓣膜病变、冠状动脉血管炎炎以及心脏电传导系统异常等。而合并心脏受累的患者预后普遍较差。临床上AAV患者明显心脏受损的症状少见，亚临床心脏受累可能被诊断不足且未得到充分治疗，这显著增加了患者的死亡风险。基于ANCA相关性血管炎心脏受累的临床现状及严重的不良预后，本文将综述该领域报道的最新进展，以提高临床医师对AAV心脏受累的重视。
      【关键词】 ANCA相关性血管炎；流行病学；心血管疾病；临床特点；治疗
      【中图分类号】 R543 【文献标识码】 A 【文章编号】 1003—6350（2021）21—2804—04

Research progress of ANCA-associated vasculitis with cardiac involvement.
LI Nai-rong 1, LONG An-xiong 2, MAShun-gao 2. 1.Clinical College, Dali University, Dali 671000, Yunnan, CHINA; 2. People's Hospital of Dali Bai AutonomousPrefecture, Dali 671000, Yunnan, CHINA【Abstract】 Antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) is a rare and serious in-flammatory disease of small and medium blood vessels. The 2012 International Chapel Hill Consensus Conference clas-sified it into granulomatosis with polyangiitis (Wegener's, GPA), microscopic polyangiitis (MPA), and eosinophilic gran-ulomatosis with polyangiitis (Churg-Strauss, EGPA). These three types of AAV can cause heart involvement, often mani-fested as pericarditis, myocarditis, heart valve disease, coronary vasculitis, and abnormalities in the electrical conductionsystem of the heart. The prognosis of patients with heart involvement is generally poor. Clinically, the symptoms of obvi-ous cardiac damage in AAV patients are rare, and subclinical cardiac involvement may be underdiagnosed and undertreat-ed, which significantly increases the patient's risk of death. Based on the clinical status of ANCA-associated vasculitisand the serious adverse prognosis, this article will review the latest developments reported in this field in order to in-crease the attention of clinicians to AAV cardiac involvement.
      【Key words】 ANCA associated vasculitis (AAV); Epidemiology; Cardiovascular diseases; Clinical features;Treatment·综述·doi:10.3969/j.issn.1003-6350.2021.21.023