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白塞病的眼部表现(对皮肤科就诊的50例患者的研究)

[Ocular manifestation of Behçet disease (study of 50 patients consulting in dermatology department)].

作者信息

Janati K, EL Omari K, Benchiki H, Hamdani M, Lakhdar H

机构信息

Service de dermatologie vénéréologie, CHU Ibn-Rochd, quartier des hôpitaux, Casablanca, Maroc.

出版信息

Rev Med Interne. 2005 Oct;26(10):771-6. doi: 10.1016/j.revmed.2005.06.015. Epub 2005 Aug 18.

Abstract

INTRODUCTION

Behçet disease is a multisystemic vascularitis. Ocular affection is one of the major criteria of this disease. The aim of this study is to specify the clinical, therapeutical characteristics and the prognosis factors of the ocular affection in patients having BD and admitted to the dermatology department.

PATIENTS AND METHODS

It is a retrospective investigation carried out in the dermatology department of Ibn Rochd university hospital center of Casablanca, Morroco, from Jannuary 1990 until December 2003. Two patient groups have been distinguished. The first one involved 50 patients (44,2%) having BD with ocular affection, and the second group involved 63 patients having BD without ocular affection.

RESULTS

The mean age was 29 +/- 8 years in the first group VS 30 +/- 7,9 years in the 2(nd) group. The ocular affection was more frequent in males than in females (P < 0.05). The ocular manifestations were marked by uveitis and retinal periphlebitis. The frequency of the cutaneomucosal and joint manifestations was similar in both groups, whereas neurologic and vascular with ocular affections. The choice of the treatment depended on the type of ocular affection. Evolution was marked by blindness in 6 patients (12%).

DISCUSSION

The ocular affection comes second after the cutanous mucuous affection. Males are more clearly affected than females. This allows saying that there is a marked effect of the sexual hormones on the ocular affection. Age is not predictive of this ocular affection. The ocular affection was severe in our series and was dominated by uveitis and vascularitis. We insist on the severity of ocular Behçet and its evolution? Risk toward blindness especially concerning young man. Currently, the treatment is not codified; however, the encouraging outcome obtained with some immunosuppressive therapies would be better if this treatment was set up early.

CONCLUSION

This study enebed us to re-examine the ocular manifestations of the Behçet disease in the Maroccan population by the means of a consultation of Dermatology. Il should be noted that it is worse forecast because on the one hand of its frequent association to vascular and neurological affections and other share of the delay of consultation noted at the majority of our patients.

摘要

引言

白塞病是一种多系统血管炎。眼部病变是该疾病的主要标准之一。本研究的目的是明确患有白塞病并入住皮肤科的患者眼部病变的临床、治疗特征及预后因素。

患者与方法

这是一项在摩洛哥卡萨布兰卡伊本·鲁西德大学医院中心皮肤科进行的回顾性研究,时间跨度为1990年1月至2003年12月。区分了两组患者。第一组包括50例(44.2%)患有眼部病变的白塞病患者,第二组包括63例无眼部病变的白塞病患者。

结果

第一组的平均年龄为29±8岁,第二组为30±7.9岁。眼部病变在男性中比女性更常见(P<0.05)。眼部表现以葡萄膜炎和视网膜静脉周围炎为主。两组皮肤黏膜和关节表现的发生率相似,而神经系统和血管病变在有眼部病变的患者中更常见。治疗方案的选择取决于眼部病变的类型。6例患者(12%)出现失明,病情进展明显。

讨论

眼部病变仅次于皮肤黏膜病变。男性比女性受影响更明显。这表明性激素对眼部病变有显著影响。年龄不能预测眼部病变。在我们的系列研究中,眼部病变较为严重,以葡萄膜炎和血管炎为主。我们强调眼部白塞病的严重性及其病情进展,尤其是对年轻人而言有失明风险。目前,治疗方法尚无统一规范;然而,如果能早期进行一些免疫抑制治疗,所取得的令人鼓舞的疗效将会更好。

结论

本研究使我们能够通过皮肤科会诊重新审视摩洛哥人群中白塞病的眼部表现。应该指出的是,其预后较差,一方面是因为它常与血管和神经病变相关,另一方面是因为我们大多数患者就诊延迟。

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