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白塞病的心血管异常事件。

Unusual cardiovascular events in Behçet's disease.

机构信息

Department of Internal Medicine, Bichat-Claude Bernard Hospital, Paris-7 University, Paris, France.

出版信息

Clin Exp Rheumatol. 2010 Jul-Aug;28(4 Suppl 60):S82-5. Epub 2010 Sep 24.

Abstract

OBJECTIVES

To report on cardiovascular involvement in Behçet's disease (BD).

METHODS

A retrospective analysis of clinical, EKG, echodoppler, CT-scan, MRI, conventional angiography, treatment and follow-up data was undertaken in 4 patients suffering BD.

RESULTS

Cardiac specific complications included coronary artery involvement (n=3), endomyocardial fibrosis (n=1), left ventricle spontaneous rupture with giant wall pseudo-aneurysm (n=1), and massive left ventricle thrombosis (n=1). Follow-up ranged from 1 month to 17 years. Surgery was complicated with vascular patch leakage, recurrent pseudo-aneurysm or upper-limb venous thrombosis in 2 patients who did not receive pre-operative specific treatment because of delayed BD diagnosis. High-dose steroids (n=4), colchicine (n=4), immunosuppressants (n=3) and anticoagulants (n=4) were eventually prescribed and stabilised cardiac disease in all cases.

CONCLUSIONS

At time of life-threatening cardiac complications, BD was often overlooked. Prompt initiation of steroids and immunosuppressive treatment may prevent post-operative complications, recurrences and death.

摘要

目的

报告白塞病(BD)的心血管受累情况。

方法

对 4 例患有 BD 的患者的临床、心电图、超声心动图、CT 扫描、MRI、常规血管造影、治疗和随访数据进行回顾性分析。

结果

心脏特异性并发症包括冠状动脉受累(n=3)、心肌纤维化(n=1)、左心室自发性破裂伴巨大壁假性动脉瘤(n=1)和巨大左心室血栓形成(n=1)。随访时间从 1 个月到 17 年不等。由于 BD 诊断延迟,2 例患者未接受术前特异性治疗,手术时出现血管补片渗漏、复发性假性动脉瘤或上肢静脉血栓形成。最终,4 例患者接受了大剂量类固醇(n=4)、秋水仙碱(n=4)、免疫抑制剂(n=3)和抗凝剂(n=4)治疗,所有患者的心脏疾病均得到稳定。

结论

在危及生命的心脏并发症发生时,BD 往往被忽视。及时开始类固醇和免疫抑制治疗可能预防术后并发症、复发和死亡。

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