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抗髓过氧化物酶抗体的核周型抗中性粒细胞胞浆抗体(p-ANCA)和抗蛋白酶3抗体的胞浆型抗中性粒细胞胞浆抗体(c-ANCA)在有肾脏受累的患者中界定了不同的血管炎实体。

p-ANCA with myeloperoxidase antibodies and c-ANCA with proteinase 3 antibodies define a different vasculitis entity in patients with renal involvement.

作者信息

Dringenberg C, Apenberg S, Andrassy K

机构信息

Dept. of Medicine, University of Heidelberg, FRG.

出版信息

Adv Exp Med Biol. 1993;336:445-7. doi: 10.1007/978-1-4757-9182-2_79.

Abstract

In a 3 year period 359/3685 patients with suspected vasculitis had a positive ANCA-IF. C-ANCA were found in 146/359 and p-ANCA in 213/359 patients. P-ANCA and MPO-antibodies were more frequently associated with female gender and preglomerular vasculitis, whereas c-ANCA (WG) were more frequent in males without renal vasculitis. Detection of anti-neutrophil cytoplasmic antibodies (ANCA) has facilitated the diagnosis of Wegener's granulomatosis (WG) and microscopic polyarteritis (MP), important representatives of small vessel vasculitides (SVV). C-ANCA with proteinase 3 antibodies (PR 3-AB) are typical of WG and p-ANCA with myeloperoxidase antibodies (MPO-AB) are typical of MP in our country. We reported recently about an association between crescentic glomerulonephritis, renal vasculitis, p-ANCA, myeloperoxidase-AB and female gender in a small cohort of patients with rapidly progressive glomerulonephritis (RPGN). In the following we analyzed whether in a larger cohort of patients with SVV this preliminary statements could be confirmed.

摘要

在3年期间,3685例疑似血管炎患者中有359例抗中性粒细胞胞浆抗体免疫荧光法(ANCA-IF)呈阳性。359例患者中,146例检测到胞浆型抗中性粒细胞胞浆抗体(C-ANCA),213例检测到核周型抗中性粒细胞胞浆抗体(p-ANCA)。p-ANCA和髓过氧化物酶抗体(MPO-抗体)在女性和肾小球前血管炎患者中更常见,而C-ANCA(韦格纳肉芽肿,WG)在无肾血管炎的男性中更常见。抗中性粒细胞胞浆抗体(ANCA)的检测有助于诊断韦格纳肉芽肿(WG)和显微镜下多血管炎(MP),这两种疾病是小血管血管炎(SVV)的重要代表。在我国,伴有蛋白酶3抗体(PR 3-AB)的C-ANCA是WG的典型表现,伴有髓过氧化物酶抗体(MPO-AB)的p-ANCA是MP的典型表现。我们最近报道了一小群快速进展性肾小球肾炎(RPGN)患者中新月体性肾小球肾炎、肾血管炎、p-ANCA、髓过氧化物酶抗体和女性之间的关联。在接下来的研究中,我们分析了在更大的SVV患者队列中,这一初步结论是否能够得到证实。

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