Bulanov N M, Novikov P I, Litvinova M A, Moiseev S V
Sechenov First Moscow State Medical University (Sechenov University).
Ter Arkh. 2022 Jun 17;94(5):704-708. doi: 10.26442/00403660.2022.05.201503.
Systemic vasculitis is a manifold group of systemic autoimmune diseases characterized by the inflammation of the blood vessels. The first clinical cases of systemic vasculitis were described in the Middle Ages, and most of the currently recognised nosological forms were reported in the first half of the 20th century. The first attempt to create a united classification of vasculitis was performed by P. Zeek in 1952. In the following decades accumulation of the data on the etiology and pathogenesis of different vasculitis guided researchers from different countries in their attempts to improve classification. The main principles of classification were the size of the affected blood vessels, disease etiology and pathogenesis. In 1990 American College of Rheumatology (ACR) published classification criteria for seven forms of the systemic vasculitis, that gave a significant contribution to the conduction of large-scale studies in this field. However, the first international nomenclature of vasculitis was developed only in 1994 during the Consensus Conference in Chapel Hill. Revised and augmented version of this nomenclature was created in 2012 and is still valid. An important step in the development of the classification of vasculitis was a joint project of ACR and EULAR aimed to develop new diagnostic and classification criteria for vasculitis (DCVAS). The first result of this project are the new classification criteria for granulomatosis with polyangiitis, microscopic polyangiitis and eosinophilic granulomatosis with polyangiitis published in 2022. In general, the evolution of the classification of vasculitis occurs under the influence of the progress in the understanding of their etiology and pathogenesis.
系统性血管炎是一组多样的系统性自身免疫性疾病，其特征为血管炎症。系统性血管炎的首批临床病例在中世纪就有描述，而目前大多数公认的病种形式在20世纪上半叶就已被报道。1952年P. 齐克首次尝试对血管炎进行统一分类。在接下来的几十年里，不同血管炎病因和发病机制数据的积累引导着来自不同国家的研究人员努力改进分类。分类的主要原则是受累血管的大小、疾病病因和发病机制。1990年，美国风湿病学会（ACR）发布了七种系统性血管炎形式的分类标准，这对该领域大规模研究的开展做出了重大贡献。然而，血管炎的首个国际命名法直到1994年在查珀尔希尔共识会议期间才得以制定。该命名法的修订和扩充版本于2012年创建，至今仍然有效。血管炎分类发展中的一个重要步骤是ACR和欧洲抗风湿病联盟（EULAR）的一个联合项目，旨在制定血管炎的新诊断和分类标准（DCVAS）。该项目的首个成果是2022年发布的肉芽肿性多血管炎、显微镜下多血管炎和嗜酸性肉芽肿性多血管炎的新分类标准。总体而言，血管炎分类的演变是在对其病因和发病机制理解的进步影响下发生的。
