伴肾脏受累的原发性小血管炎的诊治探讨

目的 :探讨伴肾脏受累的原发性小血管炎的早期诊断和合理治疗。方法 :对 7例原发性小血管炎伴肾脏受累患者的临床资料进行回顾性分析。结果 :7例中 1例肾功能严重受损 ,经甲泼尼龙冲击 (后改口服激素治疗 )及血液透析治疗 ,病情曾一度好转 ,因突发肺出血、上消化道出血死亡 ,其余 6例经激素、环磷酰胺冲击治疗 ,病情稳定 ,肾功能好转或正常。结论 :伴肾脏受累的原发性小血管炎 ,早期诊断、早期适当治疗是改善预后的关键。

Diagnosis and Treatment of Primary Small-vessel Vasculitis with Renal Involvement

Objective: To investigate the diagnosis and treatment of primary small-vessel vasculitis with renal involvement. Methods: 7 cases with primary small-vessel vasculitis with renal involvement were analyzed retrospectively. Results: The combined bolus treatment with corticosteroid and CTX were effective in 6 cases, these patients achieved better prognosis, 1 patient with severe renal damage had received hemo-dialysis and corticosteroid treatment and once became better, but died from profuse pulmonary and upper gastrointestinal tract hemorrhage. Conclusion: Early diagnosis and proper treatment for patients with primary small-vessel vasculitis with renal involvement play a key role in improving the prognosis.