Clinical Analysis Of ANCA Associated Vasculitis Patients With Lung Involvement

Object:To retrospective analysis the clinical characteristics and related risk factors of patients with antineutrophil cytoplasmic antibody(ANCA)associated vasculitis(AAV)with lung involvement.The clinical features of AAV with interstitial lung disease(AAV-ILD)with different AAV with DAH were compared.The study was to guide the clinical diagnosis and treatment,and to improve the prognosis of the patients.Methods:The clinical date of 116 Patients was diagnosed firstly in The first affiliated hospital of Chongqing Medical University from January1,2013 to January 1,2019 were analysed retrospectively.According to the presence or absence of lung involvement,the clinical characteristics of two groups were compared.We also compared the differences of the AAV-ILD with AAV-DAH.Logistic regression model was uesd to analyse the risk of AAV with lung involvement.Results:There were 116 patients with AAV,including 64 males(55.2%)and 52 females(44.8%),the average age of onset was 62years old.The first consultation department is more common in the department of nephrology(39%)and respiratory medicine(29%).The clinical characteristics of patients in AAV with lung involvement group(n=53,45.69%)were compared with AAV without lung involvement group(n=63,54.3%):the onset age was higher(66.85±9.90vs57.97±15.53,t=3.727,P=0.00),and cough and expectoration symptoms(56.60%vs 30.15%,χ~2=8.251,P=0.004)were more common.MPO-ANCA positive were included in Logistic analysis with sex(male),age>66 years.The results showed that age>66 years and the positive of MPO-ANCA were the risk factor of AAV with lung involvement.Conclusion:1.the onset age in the AAV with lung involvement was higher than that in the AAV without lung involvement,and the age>66years was the risk factor of AAV with lung involvement.2.The clinical symptoms are non-specific,mostly manifested as cough and sputum,dyspnea,hemoptysis/blood in sputum.Some patients even have no respiratory symptoms.So attention should be paid to chest HRCT screening.Early intervention for lung damage can reduce its impact on prognosis.3.There are mainly MPO-ANCN positive in patients of AAV.There is statistical difference between lung involvement and non-involvement.4.Most of the patients present with interstitial changes,which are more prone to ground glass shadows and grid shadows,and honeycomb lung and lung fibrosis may appear later.