42例白塞病心脏损害患者的临床特点分析

Clinical characteristics of Behcet's disease with cardiac involvement——an analysis of forty-two cases

目的分析白塞病患者心脏受累的临床特点。方法回顾性分析北京协和医院1990-2006年确诊的心脏受累的白塞病患者的临床资料。结果我院1990-2006年住院治疗的白塞病患者348例,有心脏受累的白塞病患者42例,占12.1%。心脏受累的表现主要有瓣膜病变(17例)、心绞痛(12例)、心包积液(10例)、心律失常(4例)、心腔血栓(5例)、肺动脉高压(10例)等。42例患者采用糖皮质激素治疗,33例用免疫抑制剂治疗,其他治疗还有动脉瘤患者置入带膜支架、主动脉换瓣、动脉瘤手术切除、下腔静脉血栓置网、右室血栓手术取栓等,手术换瓣或介入治疗的效果与全身白塞病的活动性有关。42例患者好转30例,占71.4%。恶化6例,占14.3%。住院死亡6例,占14.3%。logistic 回归分析显示,肺动脉受累是白塞病心脏损害患者死亡的独立相关因素(P=0.03)。结论白塞病累及心脏的表现多种多样;需要换瓣手术或者介入治疗者,应在白塞病非活动期进行;肺动脉受累是有心脏受累的白塞病患者死亡的独立危险因素。

Objective To analyze the clinical characteristics of Behcet＇s disease with cardiac involvement. Methods Patients diagnosed as Behcet＇s disease with cardiac involvement in Peking Union Medical College Hospital from 1990 to 2006 were included in this analysis. The clinical characteristics of these patients were studied retrospectively. Results Forty-two patients were included. Cardiac involvement included valvular disease, angina, pericardial effusion, arrhythmia, intracardiac thrombus and pulmonary artery hypertension. The effect of valve replacement or intervention treatment was related to the activity of Behcet＇s disease. The involvement of pulmonary artery was an independent correlative factor of mortality （P = 0. 03）. Conclusions The manifestation of cardiac involvement in Behcet＇s disease is various. If needed,valve replacement operation and intervention treatment should be performed when the Behcet＇s disease is stable. The involvement of pulmonary artery is an independent correlative factor of mortality.