论文部分内容阅读
目的 评价抗中性粒细胞胞浆抗体相关性血管炎（ＡＳＶ）肾脏损害及救治疗效。方法１９９７．１０～２００１．３间确诊ＡＳＶ ５６例，急诊肾穿刺活检２１／５６例，依据病情活动度和病损程度分别予以双冲击、单冲击、单纯激素和（或）小剂量ＣＴＸ、单纯或联合血液净化，追踪缓解率。结果ＡＳＶ中肾累及率９６．４％，肾功能衰竭（肾衰）９１．１％，急性肾衰８２．ｌ％，重度肾衰４８．２％，病理以新月体性肾炎和局灶节段性肾炎常见。病死率１９．６％，缓解率６７．９％，失访率１２．５％。结论 ＡＳＶ患者肾损害发生率高，病情重；应强调“个体化”，早期治疗、合理干预，加强随访，急诊肾活检有助完善诊断；已进展至终末期者仍有免疫抑制剂应用指征。
Objective To evaluate the effects of anti-neutrophil cytoplasmic antibody-associated vasculitis (ASV) on kidney damage and treatment. Methods Fifty-six patients with confirmed ASV and 21/56 patients with acute renal biopsy from 1997.10 to 2001.3 were treated with double impact, single-impact, single hormone and / or low-dose CTX respectively according to disease activity and lesion degree. Or combined with blood purification, tracking response rate. Results The incidence of renal involvement in ASV was 96.4%, renal failure (renal failure) 91.1%, and acute renal failure 82. l%, severe renal failure 48.2%, pathology to crescentic nephritis and focal segmental nephritis common. The mortality rate was 19.6%, the response rate was 67.9%, and the rate of loss to follow up was 12.5%. Conclusions The incidence of renal damage in ASV patients is high and the condition is serious. Individualized, early treatment, rational intervention, enhanced follow-up and emergency renal biopsy should be used to improve the diagnosis. Patients who have progressed to the final stage may still have indications of immunosuppressive agents .