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目的 提高对显微镜多血管炎临床特征的认识。方法 报道 5例显微镜多血管炎 ,并进行文献复习。结果 4例以发热 ,3例以关节肿痛 ,1例以腹痛、腹泻和胃肠道出血为起病症状。 5例都有肾损害 ,3例肺受累。 5例血沉都增快 ,C反应蛋白增高 ,有不同程度贫血和低蛋白血症 ,补体都正常 ,核周型 抗中性粒细胞胞质抗体 (p ANCA)和髓过氧化物酶 抗中性粒细胞胞质抗体 (MPO ANCA)都阳性。结论 不明原因的长期发热、关节肿痛伴肺肾受累 (尤其肾功能急剧恶化的肾小球肾炎而无肾性高血压 ,不明原因的咯血 ) ,补体正常 ,p ANCA和MPO ANCA阳性 ,排除继发性小血管炎 ,应诊断显微镜多血管炎
Objective To improve the understanding of the clinical features of microscopic polyangiitis. Methods Five cases of microscopic vasculitis were reported and reviewed. Results 4 cases of fever, 3 cases of joint swelling and pain, 1 case of abdominal pain, diarrhea and gastrointestinal bleeding for the onset of symptoms. 5 cases had kidney damage, 3 cases of lung involvement. 5 cases of ESR are faster, C-reactive protein increased, with varying degrees of anemia and hypoproteinemia, complement were normal, perinuclear anti-neutrophil cytoplasmic antibody (p ANCA) and myeloperoxidase anti-neutral Granulocyte cytoplasmic antibodies (MPO ANCA) are positive. CONCLUSIONS: Long-term fever of unknown cause, joint swelling and pain with pulmonary involvement (especially glomerular nephritis with rapidly deteriorating renal function without renal hypertension and unexplained hemoptysis), normal complement, positive ANCA and MPO ANCA, Vasculitis, microscopic polyangiitis should be diagnosed