在诊断,分类和预后的挑战与ANCA相关的血管炎
Marta Casal Moura1,2, Peter A Merkel3,4, David Jayne5
1Division of Nephrology and Hypertension, Department of Medicine, Mayo Clinic College of Medicine and Science, Rochester, MN, USA. casalmoura.marta@mayo.edu.
Nature reviews. Rheumatology
|October 16, 2025
概括
由于疾病的复杂性和各种测试,诊断和分类抗中性粒细胞质抗体 (ANCA) 相关的血管炎 (AAV) 存在挑战. 本综述解决了这些问题,以改善个性化患者护理.
科学领域:
- 类风湿病学 类风湿病学
- 腎臟病學 (nephrology) 是一種醫學專業.
- 免疫学 免疫学 免疫学
背景情况:
- 抗中性细胞质抗体 (ANCA) 相关的血管炎 (AAV) 包括多炎的颗粒瘤 (GPA),微观多炎 (MPA) 和多炎的异性颗粒瘤 (EGPA).
- 由于临床异质性,重叠条件和可变的ANCA测试性能,诊断是复杂的.
研究的目的:
- 审查目前在AAV的诊断,分类和预后评估方面的挑战和机会.
- 概述个性化,以结果为中心的AAV护理的框架.
主要方法:
- 综合症状,体检,实验室测试,病原体学和成像.
- 基于表型和ANCA特异性的不断发展的分类系统的审查.
- 评估现有的疾病活动,损伤和预后工具.
主要成果:
- 尽管取得了进展,但AAV诊断,分类和预后评估仍然具有挑战性.
- 新兴疗法改善了结果,但高发病率和死亡率风险仍然存在.
- 在识别微妙的疾病,不可逆转的损伤和复发风险方面存在局限性.
结论:
- 需要一个结构化的方法来支持个性化和以结果为中心的AAV患者的护理.
- 解决诊断和预后复杂性对于改善患者管理和结果至关重要.
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