结节性多动脉炎的诊断和治疗进展

结节性多动脉炎（PAN）是最早被阐述的系统性血管炎，是累及中等大小动脉或小动脉的一种坏死性血管炎，常有多系统受累。临床表现复杂且缺乏特异性，往往没有肾小球肾炎、肺损害及抗中性粒细胞胞浆抗体（ANCA）。PAN的诊断依赖于临床表现、实验室检查以及病理检查，找出其重要线索如：周围神经病变、胃肠道损害、高血压、HBsAg阳性等才能作出正确诊断。PAN的治疗主要是肾上腺糖皮质激素，对有重要脏器损害的患者使用细胞毒药物和血浆置换也是必要的。

Diagnosis and treatment of polyarteritis nodosa(PAN)

Polyarteritis nodosa (PAN) is one of the earliest forms of systemic vasculitis described. PAN is a multisystem inflammatory disease associated with necrosis of small and medium arteries.The clinical situations are complex and lack of specificity. It is charactered by lack of glomerulonephritis,lung lesions and antineutrophil cytoplasmic antibodies(ANCA).Establishing a definitive diagnosis of polyarteritis nodosa is therefore challenging,and mandates dialogue between the pathologist and the clinician primed with pertinent clinical and laboratory data,finding the important significance such as the lesions of peripheral nerve and gastrointestinal tract, hypertension, the positive of HBsAg. The treatment of PAN should be mainly started with steroids.For patients with the lesion of important organs, cytotoxic drugs and plasma exchange are necessary.