Clinical-pathological Analysis Of Primary Systemic Small Blood Vessel Vasculitis And Systemic Lupus Erythematosus With Necrotizing Lesions

Objective:to investigate the the clinical and pathological characteristics of primary systemic small blood vessel vasculitis(PSV)and systemic lupus erythematosus with necrotizing lesions.Methods:81 patients with primary systemic small blood vessel vasculitis(PSV)and systemic lupus erythematosus diagnosed in recent 4 years in our center were retrospectively studied and their clinical and pathological data were analyzed.Results:The patients with PSV were older than the patients with SLE(PSV vs SLE:55.33±14.57vs32.00±14.08).All of them had renal and lung involvement,the rates of renal involvements were 89.7%and 100%,the rate of acute renal damage in group PSV is 28.2%,higher than group SLE.the prevalences of hyperproteinuria, crescentic formation and immumofluorescence of renal pathology were significantly higher in patients with PSV than those in patients with SLE(P＜0.05).The prevalenees of haemoptysis and cough were significantly higher in patient with PSV than those in patients with SLE(P＜0.05).Before be treated,the white blood cell and C-reactive protein were increased in the patients with PSV(P＜0.01).The prevalences of ANCA positive were significantly higher in patients with PSV than those in patients with SLE(86.5%vs37.2%,P＜0.01).The level of blood fat and blood uric acid are higher in the patients with PSV than those with SLE.The patients were treated with corticosteroid and cyclophosphamide.The remissiom rates induction phase were significantly higher in patients with SLE than those in patients with PSV(93%vs76.3%,P＜0.05).Conclusion:1.Acute renal injury can be found in some patients with PSV,the chronic damage of renal,such as glomerular sclerosis and interstitial fibrosis,is severity in the patients with PSV.In the patients with vessal necrotic lupus nephritis,haemuresis and ponderosus proteinuria are common and the crescent formation is severity.2.Laboratary exaninations reveal elevated WBC in lots of patients with PSV. 3.ANCA examination has the vital clinical significance to the diagnosis.The diagnosis of PSV must find out the evidence of cinical and the other laboratory datas.4.The remission rate is higher in the patients with vessal necrotic lupus nephritis than those with PSV.