抗中性粒细胞胞浆抗体阴性的少免疫沉积型新月体性肾小球肾炎15例分析

目的　了解抗中性粒细胞胞浆抗体 (ANCA)阴性的少免疫沉积型新月体肾炎的临床病理特点。方法　对近 10年来诊断为少免疫沉积型新月体肾炎患者进行ANCA检测 ,并对其中ANCA阴性患者进行临床病理分析。结果　 33例少免疫沉积型新月体肾炎中 ,ANCA阴性患者 15例 ,占 4 5 % ,为同期所有新月体肾炎的15 %。其中 9例伴多系统受累 ,6例仅累及肾脏。 2例患者病理可见小血管炎。经积极治疗 ,1/13例临床痊愈 ,6 /13例临床缓解 ,6 /13例无效。结论　ANCA阴性少免疫沉积型新月体肾炎在临床、病理上与ANCA阳性病人相似 ,但好发年龄偏低 ,预后相对较差

ANCA-neagtive pauci-immune crescentic glomerulonephritis

Objectives To study the clinical and pathological features of patients with ANCA-negative pauci-immune crescentic glomerulonephritis.Methods ANCA was detected and the clinical and pathological features were analyzed in 33 patients with pauci-immune crescentic glomerulonephritis.Results Of the 33 patients with pauci-immune crescentic glomerulonephritis, 15(45%) were ANCA negative, which accounted for 15% of the patients with crescentic glomerulonephritis. Of the 15 patients with negative ANCA,9 had multi-system involvement and 6 were clinically limited to kidney only. Renal biopsies showed small vessel vasculitis in 2 patients. After intensive immunosuppressive therapy, one out of thirteen patients was cured,six achieved clinical remission,while the other 6 became dialysis dependent.Conclusions The clinical and pathological features of the patients with ANCA-negative pauci-immune crescentic glomerulonephritis are similar to those with ANCA-positive,while the ages of these patients are younger and the prognosis poorer.