Sumethkul V, Changsirikulchai S, Radinahamed P, Chalermsanyakorn P
Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Asian Pac J Allergy Immunol. 1999 Dec;17(4):281-7.
The impact of vasculitis as a cause of primary rapidly progressive crescentic glomerulonephritis (RPGN) was examined in patients with Thai ethnic by antineutrophil cytoplasmic antibody (ANCA) test. Thirty patients found in a six years study period were included. Patients' mean age was 34.8+/-16.4 years. Mean crescent score was 86.2+/-22.9%. ANCA proved positive in fifteen patients. This helps to differentiate vasculitis associated (ANCA positive) from nonvasculitis (ANCA negative) RPGN. Incidence of immune complex type RPGN (46.6%) is higher than the Caucasians while the incidence of antiglomerular basement membrane antibody (anti-GBM disease) is much lower. More vasculitis patients were treated with cyclophosphamide (n = 11) than the nonvasculitis group (n = 2). Mean renal survival time of ANCA and non-ANCA associated patients were 26.69 and 14.16 months, respectively. Renal survival of all patients is significantly worse if associated with a high entry creatinine (>6 mg/dl). Our results show that vasculitis associated RPGN is not an uncommon disease in the Thai population and can be recognized initially by ANCA test.
通过抗中性粒细胞胞浆抗体（ANCA）检测，在泰国裔患者中研究了血管炎作为原发性快速进展性新月体性肾小球肾炎（RPGN）病因的影响。纳入了在六年研究期间发现的30例患者。患者的平均年龄为34.8±16.4岁。平均新月体评分是86.2±22.9%。15例患者ANCA检测呈阳性。这有助于区分血管炎相关性（ANCA阳性）与非血管炎（ANCA阴性）RPGN。免疫复合物型RPGN的发病率（46.6%）高于白种人，而抗肾小球基底膜抗体（抗GBM病）的发病率则低得多。接受环磷酰胺治疗的血管炎患者（n = 11）比非血管炎组（n = 2）多。ANCA相关性和非ANCA相关性患者的平均肾脏存活时间分别为26.69个月和14.16个月。如果入院时肌酐水平高（>6mg/dl），所有患者的肾脏存活率会显著降低。我们的结果表明，血管炎相关性RPGN在泰国人群中并非罕见疾病，最初可通过ANCA检测识别。
