Cameron J S
Clinical Science Laboratories, Guy's Hospital, London, United Kingdom.
Ann Med Interne (Paris). 1988;139(2):103-7.
Vasculitis is commoner than supposed, since its manifestations are Protean. A simple classification of vasculitis is outlined and an approach to renal vasculitis described. Recent papers on the subject are summarized, and recent advances in understanding of the role of cell-mediated immunity in the pathogenesis of vasculitis outlined. The treatment of renal vasculitis accompanied by renal insufficiency is summarized, with a note on Henoch-Schönlein purpura. The prognosis for patients with severe renal vasculitis, whether Wegener's granuloma or microscopic polyarteritis, has improved considerably over the past three decades, using immunosuppression with corticosteroids, orally or intravenously, cytotoxic agents, and plasma exchange backed up by dialysis as necessary. The principal problems now relate to the management of immunosuppression in the long term survivors.
血管炎比人们想象的更为常见，因为其表现形式多种多样。本文概述了血管炎的简单分类，并描述了肾血管炎的诊疗方法。总结了近期关于该主题的论文，并概述了在理解细胞介导的免疫在血管炎发病机制中的作用方面的最新进展。总结了伴有肾功能不全的肾血管炎的治疗方法，并对过敏性紫癜作了说明。在过去三十年中，无论是韦格纳肉芽肿还是显微镜下多动脉炎，采用口服或静脉注射皮质类固醇、细胞毒性药物进行免疫抑制，并在必要时辅以透析和血浆置换，严重肾血管炎患者的预后有了显著改善。目前主要的问题与长期存活者的免疫抑制管理有关。
