Piette J C, Du L T, Cacoub P, Papo T, Wechsler B
Service de Médecine Interne, Groupe Hospitalier Pitié-Salpêtrière, Paris.
Rev Pneumol Clin. 1994;50(1):21-5.
Pulmonary vasculitides require major therapeutic regimens which, though symptomatic, are often effective. Corticosteroids have greatly changed the prognosis of most of these vasculitides, particularly polyarteritis nodosa and the Churg and Strauss syndrome. Cyclophosphamide must be added for Wegener's granulomatosis although the route of administration is still under discussion. Plasma exchanges are rarely indicated. Other treatments for Wegener's granulomatosis including combined trimethoprim-sulfamethoxazole in limited forms and methotrexate in sub-acute systemic forms are currently under study. A better understanding of the underlying mechanisms, including the role of antineutrophil cytoplasmic antibodies, and especially the identification of the causative factors will lead to an aetiologic treatment still unknown today.
肺血管炎需要采用主要的治疗方案，这些方案虽有症状性，但往往有效。皮质类固醇极大地改变了大多数这类血管炎的预后，尤其是结节性多动脉炎和变应性肉芽肿性血管炎。对于韦格纳肉芽肿病必须加用环磷酰胺，尽管给药途径仍在讨论中。血浆置换很少使用。目前正在研究韦格纳肉芽肿病的其他治疗方法，包括有限形式的复方新诺明联合用药以及亚急性全身形式的甲氨蝶呤。对潜在机制的更好理解，包括抗中性粒细胞胞浆抗体的作用，尤其是致病因素的识别，将导致一种目前尚不清楚的病因治疗方法。
