Grotz W, Mundinger A, Würtemberger G, Peter H H, Schollmeyer P
Department of Medicine, University of Freiburg, Germany.
Chest. 1994 Feb;105(2):509-13. doi: 10.1378/chest.105.2.509.
Eleven patients with generalized Wegener's granulomatosis were studied. Pulmonary involvement occurred 1 month earlier than a rapid rise of serum creatinine value. Under immunosuppressive therapy, nodules and infiltrations abated slower in patients with bronchopulmonary superinfection (mean, 30 days) compared with patients without superinfection (mean, 18 days). In the short run, radiographic course was a better indicator for therapeutic success than the course of cytoplasmatic antineutrophil cytoplasm antibody titer. If the pulmonary findings did not begin to clear within 1 week after treatment had been started, either superinfection or insufficient immunosuppression was present. In this situation, a more aggressive therapy in combination with antibiotics is suggested.
对11例广泛性韦格纳肉芽肿病患者进行了研究。肺部受累比血清肌酐值迅速升高早1个月出现。在免疫抑制治疗下，合并支气管肺超级感染的患者（平均30天）结节和浸润消退比未合并超级感染的患者（平均18天）更慢。短期内，影像学进程比细胞质抗中性粒细胞胞浆抗体滴度进程更能作为治疗成功的指标。如果在开始治疗后1周内肺部表现未开始好转，则存在超级感染或免疫抑制不足的情况。在这种情况下，建议联合使用抗生素进行更积极的治疗。
