中华临床免疫和变态反应杂志2024，Vol.18Issue(2)：110-118,9.DOI:10.3969∕j.issn.1673-8705.2024.02.002
探讨ANCA在嗜酸性肉芽肿性多血管炎分类中的价值
Explore the value of ANCA in the classification of eosinophilic granulomatous polyangi-itis
摘要
Abstract
Objective The aim of this study was to investigate the most accurate and concise classifica-tion criteria for distinguishing between the two subtypes of EGPA,characterized by vasculitis and eosinophilic infiltration,among ANCA alone,ANCA combined with pathological results,and MIRRA criteria since the classification criteria for these subtypes have not yet been clarified.Methods The present study retrospectively analyzed patients diagnosed with EGPA diagnosed in the Department of Pulmonary and Critical Care Medicine,Department of General Internal Medicine,Department of Rheumatology at Peking Union Medical College Hos-pital from January 2000 to November 2023.Based on the aforementioned three classification indexes,patients were divided into different positive and negative groups,and a comparative analysis of their clinical characteris-tics was conducted.Results A total of 245 patients were included.When classified based on ANCA results,there were 51 patients in the positive group and 194 in the negative group.The positive group exhibited higher values in terms of age(60.9 vs 55.4),NEUT%(59.12 vs 51.87),PLT(312.94 vs 264.64),ESR(55.40 vs 27.62),and CRP(46.51 vs 23.57)compared to the negative group,and all of the above indica-tors reachedstatisticalsignificance.Theinvolvementoftherenalsystem(47.1%vs25.8%)andnervoussys-tem(72.5%vs 58.2%)exhibited significantly higher prevalence in the positive group.The positive group con-sisted of 88 cases,while the negative group included 157 cases,when classified based on ANCA and patholog-ical results.The findings between these two groups were consistent with the initial results.When classified ac-cording to the MIRRA criteria,there were 161 patients in the compliant group and 84 patients in the non-com-pliant group,and the NEUT%(55.39 vs 49.58)was significantly higher in the compliant group than in the non-compliant group,and the LY%(18.57 vs 21.30)and HGB(128.80 vs 136.36)were significantly lower than in the non-compliant group.Conclusions Patients with EGPA can be classified into vasculitis subtype and eosinophilic infiltration subtype based on ANCA results.Although combining ANCA results with histopathology can also effectively differentiate between vasculitis subtypes and eosinophilic infiltrate subtypes,individualized assessment is necessary when performing pathological biopsies due to the associated risks.The MIRRA criteria are not sufficient for accurately distinguishing between the two patient groups.关键词
嗜酸性肉芽肿性多血管炎/抗中性粒细胞胞浆抗体/MIRRA研究Key words
eosinophilic granulomatosis with polyangiitis/anti-neutrophil cytoplasmic antibody/MIR-RA trial引用本文复制引用
刘怡彤,程蕴琦,彭敏,张婷,杨沛然,施举红..探讨ANCA在嗜酸性肉芽肿性多血管炎分类中的价值[J].中华临床免疫和变态反应杂志,2024,18(2):110-118,9.基金项目
国家重点研发计划常见多发病防治研究(2023YFC2507204) （2023YFC2507204）
中央高水平医院临床科研业务费(2022-PUMCH-C-017) National Key R&D Program of China(2023YFC2507204) （2022-PUMCH-C-017）
National High Level Hos-pital Clinical Research Funding(2022-PUMCH-C-017) （2022-PUMCH-C-017）
