白塞综合征眼部损害患者的临床及实验室特点分析

Analysis of clinical and laboratory characteristics of ocular damage in patients with Behcet’s syndrome

目的了解白塞病眼部损害患者的临床及实验室特点。方法搜集2008年5月-2018年5月北京大学人民医院收治的101例住院白塞病患者资料,分析眼部损害特点及其与其他系统损害及免疫学指标的关系。结果在101例白塞病患者中,有眼部损害者35例(34.6%),其中以葡萄膜炎最多见(22/35,62%),其次分别为白内障(6/35,17%)、结膜炎(4/35,12%)、角膜炎(3/35,9%)。有眼部损害和无眼部损害组相比较,男性多于女性(P<0.05),心脏瓣膜病变和动脉瘤的发生率低(均P<0.05),在口腔溃疡、外阴溃疡、皮肤损害、胃肠道、神经系统、关节、血栓形成等方面2组比较差异无统计学意义(均P>0.05)。实验室指标中抗内皮细胞抗体(AECA)的阳性率在有眼部损害组明显低于无眼部损害组(P<0.05)。在IgG升高、补体降低、D-二聚体升高、ESR、CRP及抗磷脂抗体等方面2组比较差异无统计学意义(均P>0.05),治疗以糖皮质激素、免疫抑制剂为主,患者预后较好。结论白塞病患者发生眼部损害男性多于女性,以葡萄膜炎最多见,眼部损害与发生心瓣膜病和动脉瘤呈负相关,AECA阳性率低,给予激素、免疫抑制剂、生物制剂可取得较好疗效。

Objective To understand the clinical and laboratory characteristics of ocular damage in patients with Behcet’s syndrome.Methods The patients admitted to the Department of Rheumatology and Immunology of Peking University People’s Hospital from May 2008 to May 2018 were collected to analyze the features of ocular damage and the relationship with other systemic involvement and laboratory indicators.Results Among 101 patients,35(34.6%)had ocular damage,among which uveitis was the most common(22/35,62%),followed by cataract(6/35,17%),conjunctivitis(12%)and keratitis(3/35,9%).Compared with the group without ocular damage,ocular damage occurred more in men(all P<0.05),and the incidence of heart valve disease and aneurysms was lower(P<0.05).There was no significant difference between the two groups in mucocutaneous,skin,gastrointestinal,nervous system,joint involvement and thrombosis(all P<0.05).The positive rate of anti-endothelial cell antibody(AECA)was lower in the patients with ocular damage group(P<0.05).There was no significant difference between the two groups in increasing of IgG,d-dimmer,ESR,CRP,decreasing of complement,and positive rate of anti-phospholipid antibody(all P<0.05).Conclusion The incidence of ocular damage in patients with Behcet’s syndrome is higher in male than female.Among ocular damage,uveitis is most common.Ocular damage is negatively correlated with valvular heart disease and aneurysm,the positive rate of AECA is lower in the patients with ocular damage than those without.Glucocorticoid,immunosuppressants and biological agents can get better results.