T细胞性血管炎的临床病理研究

目的 :探讨T细胞性血管炎的临床表现、分型及病理。方法 :回顾性总结 4 3例病理证实为以T淋巴细胞浸润为主的血管炎。依据其临床表现的不同将其分为局灶型 (39例 )和弥漫型 (4例 )。着重描述少见的弥漫型的临床特点。结果 :局灶型临床表现为局部皮肤红斑、关节酸痛、自限性病程及NSAIDs(非甾体抗炎药 )治疗有效 ;弥漫型表现稽留高热、网状内皮系统肿大、皮疹、无系统损害证据、白细胞数及ANCA(抗中性粒细胞胞浆抗体 )正常 ,中等以上剂量 (>1mg·kg-1·d-1)泼尼松有效 ,容易反复发作。两型病理均表现为非坏死性血管炎 ,免疫组化分析提示浸润组织的细胞为T淋巴细胞。结论 :T细胞性血管炎无论从血管炎的细胞免疫组化病理还是其临床表现、分型均与其他血管炎明显不同 ,建议单独立题命名。

Clinical and Pathological Study of Thymus Dependent Lymphocyte''''s Vasculitis

Objective: To explore clinical manifestation, type and pathological change in thymus dependent lymphocyte's vasculitis.Methods:43 cases patients of vasculitis in which T cell infiltrate mainly by biopsy were investigated retrospectively. Including 39 cases of local lesions type and 4 cases diffused type. Diffused type was described emphasizely. Results:Local lesions type showed that the nodular erythema of skin, aching pain of joints, auto-limited course of disease. It was effective by the treatment of NSAID s. Diffused type showed that more dangerous state, high fever, swelling of reticuloendothelial system, with rash. There was no damage systemically. White blood cell counting and ANCA were normal. It was effective by treatment of prednisone with mediate dosage. But it relapsed easily. Both of two type showed non-necrosis vasculitis. Immunohistochtochemical showed that tissue infiltrates were composed of T-type lymphocytes. Conclusion:Thymus dependent lymphocyte's vasculitis is different from other vasculitis distinctly in clinical manifestation, pathology, immunohisto chemical feature.