变应性肉芽肿性血管炎146例误诊原因分析

目的 探讨变应性肉芽肿性血管炎（CSS）的误诊原因.方法 回顾性分析2008年1月至2012年12月烟台市烟台山医院收治的2例及国内文献报道的144例CSS患者的临床、实验室及辅助检查资料.结果 146例CSS患者中,早期诊断正确者0例,误诊146例,早期诊断的误诊率为100%.早期误诊的疾病涉及皮肤、呼吸、循环、神经、消化、泌尿、运动等多个器官系统.其中发生哮喘109例（73.3%）,皮肤损伤91例（62.3%）,出现神经损伤的98例（67.1%）,发热77例（52.7%）,肌痛关节肿痛61a例（41.8%）,反复心肌梗死1例.结论 CSS临床表现复杂多样,不易正确诊断,对患者的临床表现和辅助检查进行综合分析,才能降低误诊率,提高治疗有效率.

Clinical Analysis on Misdiagnosis of Churg-Strauss Syndrome in 146 Cases

Objective To analyze the misdiagnosis causes of Churg-Strauss syndrome （CSS）. Methods Retrospective analysis on two cases admitted by Shandong Yantai Mountain Hospital and 144 cases repor- ted in the domestic CSS clinical literature from January 2008 to December 2012 was done, covering the labo- ratory and auxiliary examination data. Results Zero case of 146 Churg-Strauss syndrome were diagnosed correctly in the early stage, 146 cases were misdiagnosed, the early misdiagnosis rate was 100%. The clinical manifestations of CSS involved multiple systems or organs including skin, respiratory system, circulation, nerv- ous,digestive,urology and sports. Among the 146 cases, 109 （73.3%） had asthma,91 （62.3%） had skin damages, nervous system disease occurred in98 （67.1% ）cases 77 （52.7%）cases had a fever,61 （41.8%） cases had myalgia,joint swelling and pain, 1 case had recurrent myocardial infarction. Conclusion Because of the complex clinical characteristics of CSS, in order to reduo misdlagnostle rate and improve the curative rate,the clinical manifestations and auxiliary test results of the pationts must be analyzed carefully and com- prehensively.