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目的探讨原发性ANCA相关性小血管炎患者肺部受累特点及临床误诊原因。方法回顾性分析6例原发性ANCA相关性小血管炎患者的临床资料。结果4例误诊为肺部感染,接受抗感染治疗;1例诊断为狼疮性肾炎,给予血液透析治疗;1例诊断为消化道出血,给予抑酸止血治疗。结论原发性ANCA相关性小血管炎患者肺部影像学表现常以程度不同的满布两肺的点片状或斑片状模糊阴影为主。误诊原因多为对本病不认识或认识不足。
Objective To investigate the characteristics of lung involvement and the causes of clinical misdiagnosis in patients with primary ANCA-associated vasculitis. Methods The clinical data of 6 patients with primary ANCA-associated vasculitis were retrospectively analyzed. Results Four cases were misdiagnosed as pulmonary infection and received anti-infective therapy. One case was diagnosed as lupus nephritis and hemodialysis was given. One case was diagnosed as gastrointestinal bleeding and treated with acid suppression and hemostasis. Conclusions Primary pulmonary angiography in patients with primary ANCA-associated vasculitis is often dominated by patchy or patchy fuzzy shadows that fill the two lungs to varying degrees. Misdiagnosis mostly for the disease do not know or lack of understanding.