中国临床医学影像杂志2024，Vol.35Issue(1)：35-40,6.DOI:10.12117/jccmi.2024.01.008
ANCA相关性血管炎合并间质性肺病:临床表现、影像特征及预后分析
ANCA-associated vasculitis with interstitial lung disease:clinical manifestations,imaging features and prognostic analysis
摘要
Abstract
Objective:To analyze the clinical manifestations,imaging features and the prognosis of patients with ANCA-associated vasculitis(AAV)combined with interstitial lung disease(ILD),and to explore related risk factors.Methods:The clini-cal data of 51 AAV patients who were treated at Tongde Hospital of Zhejiang Province from July 2012 to June 2022 were retrospectively analyzed.According to the HRCT findings,the patients were divided into AAV combined with ILD(AAV-ILD)group and AAV without ILD(AAV-NILD)group,and the clinical manifestations,laboratory examinations,lung function,chest CT findings,and prognosis were compared between the two groups.Multiple Logistic regression models were used to analyze the risk factors associated with AAV combined with ILD.Kaplan-Meier method was used for survival analysis,and Cox pro-portional hazard regression model was used to explore the risk factors of death.Results:Among the 51 patients,there were 15 cases in the AAV-ILD group and 36 cases in the AAV-NILD group.Compared with the AAV-NILD group,the AAV-ILD group had more obvious pulmonary involvement symptoms and higher median onset age,with statistical significance(P<0.05).The survival rate of patients in the AAV-ILD group was significantly lower than that in the AAV-NILD group(Log rank,χ2=4.331,P=0.037).Age>65 years was an independent risk factor for AAV combined with ILD.Univariate survival analysis showed that smoking(HR=6.446,95%CI 1.380～30.113,P=0.018)and lung honeycomb shadows(HR=6.302,95%CI 1.174～33.817,P=0.032)were risk factors for shortened survival of AAV combined with ILD.Conclusion:Early clinical symptoms of AAV patients,such as lung involvement,should be cautious of the possibility of concomitant ILD,especially in elderly patients.Smoking and appearance of lung honeycomb shadows are risk factors for shortened survival in AAV combined with ILD patients.关键词
抗中性粒细胞胞浆抗体相关性血管炎/体层摄影术,X线计算机Key words
Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis/Tomography,X-Ray Computed分类
医药卫生引用本文复制引用
吴锶凯,徐文杰,王健,黄美春,杨光钊,敖炜群,魏福全,茅国群..ANCA相关性血管炎合并间质性肺病:临床表现、影像特征及预后分析[J].中国临床医学影像杂志,2024,35(1):35-40,6.基金项目
浙江省自然科学基金项目(LY17H290003). （LY17H290003）
