作者：Cao Y 翻译：邓晓莉 校正：张警丰，刘湘源

摘要:ANCA相关性小血管炎可以并发危及生命的出血性并发症。其中肺泡出血是最常见的、也是研究的比较透彻的一种并发症，同时也是肺-肾综合征的显著特点。肺泡出血的临床表现差别很大，可以很轻，也可能很重需要机械通气。其他一些脏器出血关注相对较少，但从发病率和死亡率角度讲也可能很严重，比如脑出血和消化道出血。脑出血是非常关键的问题，死亡率一直很高。消化道出血曾经很严重，随着药物和手术治疗的进展，其预后有所改善。其他部位出血，如皮肤、软组织和肌肉出血也不容忽视。肌肉血肿虽然少见，其发病率也不容小视。

附原文：Hemorrhagic complications of anti-neutrophil cytoplasmic autoantibody (ANCA)-associated vasculitis are life-threatening conditions. Of these, alveolarhemorrhage is the most common and well-described hemorrhagic complication and is a prominent component of the pulmonary-renal syndrome. The clinical presentation of alveolar hemorrhage is highly variable ranging from mild to serious disease that may require respiratory support. Less attention has been directed at hemorrhagic complications that have been reported in other organs and which may be as severe or more severe with regard to morbidity and mortality. For example, among the most serious non-pulmonary complications are those related to cerebral and gastrointestinal hemorrhage. Cerebral hemorrhage is the clearly the most critical issue with a persistent high mortality rate. The prognosis of gastrointestinal hemorrhage, once an ominous complication has improved with medical and surgical intervention. Not to be dismissed are the consequences of hemorrhagic issues related to skin, soft tissue or muscle involvement. Muscle hematomas, while rare, also accompanied by significant morbidity.

引自：Cao Y, Tian Z, Li W, Yang Y, Wang G. Hemorrhagic complications associated with PR3-ANCA crescentic glomerulonephritis. Ren Fail. 2015 Jun;37(5):745-50. doi: 10.3109/0886022X.2015.1014756. Epub 2015 Feb 20.