白塞病并发肺栓塞的临床特点

Cfinicai features of Behcet＇s disease complicated with pulmonary embolism and retrospective analysis

目的提高对白塞病并发肺栓塞的认识，探讨其诊断与治疗。方法收集我院3例白塞病并发肺栓塞患者，和国内1996-2011年文献检索到的6例白塞病并发肺栓塞患者的临床资料，对白塞病并发肺栓塞的临床特点进行回顾性分析总结。结果总结9例病例后发现白塞病并发肺栓塞病例多见于青年人（8／9），其中男性多见（8／9）。9例患者临床表现的特点：口腔溃疡者8例，生殖器溃疡者5例，皮肤病变者4例（假性毛囊炎1例，结节性红斑3例），针刺试验阳性1例，眼部病变者2例，有发热病史5例，咯血者8例，有咳嗽病史者4例，呼吸困难者3例，有下肢静脉血栓者5例。实验室检查6例红细胞沉降率记录中4例升高，8例c反应蛋白记录中7例升高，4例肺动脉压记录中2例升高。行CT或磁共振成像肺动脉造影诊断肺栓塞7例，余2例为核素肺通气／灌注诊断。结论肺栓塞是白塞病肺部受累的表现，治疗不仅要消除和防止血栓的复发，还要对白塞病进行积极治疗。

Objective To observe the recognition of Behcet disease（BD） complicated with pulmonary em- bolism（PE） ,and to explore the diagnosis and treatment. Methods Based on the clinical data of 3 cases of BD complicated with PE at Beijing Anzhen Hospital from 2005 to 2011, and 13 cases of BD complicated with PE reported in domestic papers from 1996 to 2011, the clinical characteristics of BD complicated with PE were analyzed and sum- marized retrospectively. Results BD complicated with PE were more common in young people （8/9） and in male （8/9）. There were 8 cases of oral ulcers, 5 cases of genital ulcers and 4 cases of skin lesions （ 1 case of pseudo fol- liculitis ,3 cases of erythema nodosum）. There were 1 case of positive prick test ,2 cases of the eye lesions ,5 cases of fever,8 cases of hemoptysis,4 cases of cough, 3 cases of breathing difficulties and 5 cases of deep vein thrombosis. Erythrocyte sedimentation rate in 4 cases increased among 6 cases who had erythrocyte sedimentation rate records. The level of C-reactive protein in 7 cases increased among 8 cases who had C-reactive protein records. Pulmonary ar- tery pressure in 2 cases increased among 4 cases who had pulmonary artery pressure records. 7 cases were diagnosed of PE by CT or MRI of pulmonary angiography, 2 cases were diagnosed of radionuclide lung ventilation/perfusion. Conclusion Pulmonary embolism is involved in the Behcet＇s disease; the treatment of the patients includes preven- tion of the recurrence of thrombosis.