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大动脉受累与白塞病综述

Major arterial involvement and review of Behcet's disease.

作者信息

Alpagut Ufuk, Ugurlucan Murat, Dayioglu Enver

机构信息

Department of Cardiovascular Surgery, Istanbul University Istanbul Medical Faculty, Istanbul, Turkey.

出版信息

Ann Vasc Surg. 2007 Mar;21(2):232-9. doi: 10.1016/j.avsg.2006.12.004.

Abstract

Behcet's disease was first defined by Hulusi Behcetin 1937 as a multisystemic disorder with characteristic pathologic findings including recurrent orogenitalulcers, vascular disorders, and ocular and cutaneous lesions. The disease is mostly encountered at the third and fourth decades of life and especially prevalent in Mediterranean and Far East Asia.Behcet's disease may have both venous and arterial manifestations. The arterial form is rare but it is bore with its manner and to consider recurrent surgical treatments. In this retrospective study, we reviewed the literature related to Behcet's disease and discussed in respect to vascular involvement and the prognosis of surgical treatment.Thirty-one consecutive patients with vasculo-Behcet's disease visiting the departments of cardiovascular surgery, dermatology, and internal medicine in Medical Faculty of Istanbul have been reviewed retrospectively. All available clinical,pathologic, and postoperative data were reviewed and analyzed. Venous system pathologies were present in 15 patients. The pathologies in the remaining patients were related to the arterial tree. Ten patients with aneurysms and/or pseudoaneurysms and six patients with occlusive lesions have undergone surgical treatment. Pseudoaneurysms occurred in six patients at least twice or more. Vascular manifestations are the main predictors of mortality and morbidity in Behcet's disease. Arterial complications may lead to difficult surgical problems.Any invasive methods to arterial system may cause pseudoaneurysms. Repairs by using autogenous veins or synthetic grafts may lead to anastomotic false aneurysms. Surgical treatment should not to be applied in the acute phase of the disease and systemic therapy including colchicine, aspirin,and corticosteroids should be considered for all patients.

摘要

白塞病于1937年由胡卢西·白塞首次定义为一种多系统疾病,具有特征性病理表现,包括复发性口腔生殖器溃疡、血管疾病以及眼部和皮肤病变。该病多见于30至40岁人群,在地中海地区和远东地区尤为普遍。白塞病可能同时有静脉和动脉表现。动脉型较为罕见,但其病情严重,需要考虑反复进行手术治疗。在这项回顾性研究中,我们回顾了与白塞病相关的文献,并就血管受累情况及手术治疗的预后进行了讨论。我们对伊斯坦布尔医学院心血管外科、皮肤科和内科连续收治的31例血管型白塞病患者进行了回顾性研究。对所有可用的临床、病理和术后数据进行了回顾和分析。15例患者存在静脉系统病变。其余患者的病变与动脉系统有关。10例患有动脉瘤和/或假性动脉瘤的患者以及6例患有闭塞性病变的患者接受了手术治疗。6例患者至少发生过两次或更多次假性动脉瘤。血管表现是白塞病死亡率和发病率的主要预测因素。动脉并发症可能导致棘手的手术问题。任何针对动脉系统的侵入性方法都可能导致假性动脉瘤。使用自体静脉或人工血管进行修复可能导致吻合口假性动脉瘤。在疾病急性期不应进行手术治疗,所有患者都应考虑采用包括秋水仙碱、阿司匹林和皮质类固醇在内的全身治疗。

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