陈怡玮;彭涛;刘希;胡文涛;石珂;王梦涵;李俊敏;卢宏;

• 1:郑州大学第一附属医院

摘要(Abstract)：

目的探讨髓过氧化物酶抗中性粒细胞胞质抗体(MPO-ANCA)相关性肥厚性硬脑膜炎(HCP)合并肉芽肿性血管炎(GPA)的临床特点、治疗及预后。方法回顾性分析2016-06—2020-06郑州大学第一附属医院神经内科住院治疗的MPO-ANCA相关性HCP合并GPA患者的临床资料。结果 5例患者均为亚急性或慢性起病,病程1个月～3 a,首发症状主要为头痛5例,脑神经受损2例。首次入院时所有患者核周型-抗中性粒细胞胞浆抗体(p-ANCA)阳性,MPO-ANCA浓度及非特异性炎症指标升高,胞质型抗中性粒细胞胞质抗体(c-ANCA)和蛋白酶3抗中性粒细胞胞质抗体(PR3-ANCA)正常,2例尿常规隐血阳性,24 h尿蛋白总量升高,颅脑MRI增强扫描均可见不同部位的硬脑膜强化及鼻窦炎,3例伴乳突炎。5例患者糖皮质激素治疗均有效,4例病情反复,3例联用免疫抑制剂治疗后症状缓解。结论 MPO-ANCA相关性HCP合并GPA病例多伴鼻窦炎、乳突炎、尿隐血、尿蛋白等,应早期给予糖皮质激素联合免疫抑制剂治疗,避免疾病向全身型发展。

关键词(KeyWords)： 髓过氧化物酶;抗中性粒细胞胞质抗体;肥厚性硬脑膜炎;肉芽肿性血管炎

Abstract:

Keywords:

基金项目(Foundation): 国家自然科学基金(编号：81971175)

作者(Authors): 陈怡玮;彭涛;刘希;胡文涛;石珂;王梦涵;李俊敏;卢宏;

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