Rheumatology Division, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.
J Eur Acad Dermatol Venereol. 2013 Apr;27(4):454-9. doi: 10.1111/j.1468-3083.2012.04458.x. Epub 2012 Feb 13.
To evaluate the structural and functional properties of vessels in Behçet's Disease (BD) using carotid-femoral pulse wave velocity (PWV) and an echo-tracking system.
BD patients without traditional cardiovascular risk factors were selected. All BD patients performed PWV and carotid ultrasound. BD patients were divided into groups based on the presence of systemic (vascular and/or ocular and/or central nervous system involvement) and vascular involvement. Healthy controls age- and sex-matched with the same exclusion criteria were selected.
A total of 23 BD patients (mean age 35.0 ± 7.6 years) had significantly higher PWV levels compared with controls (8.48 ± 1.14 vs. 7.53 ± 1.40 m/s, P = 0.017). Intima-media thickness (594.87 ± 138.61 vs. 561.08 ± 134.26 μm, P = 0.371), diastolic diameter (6383.78 ± 960.49 vs. 6447.65 ± 1159.73 μm, P = 0.840), distension (401.95 ± 117.72 vs. 337.91 ± 175.36 μm, P = 0.225) and relative distension (6.26 ± 2.83 vs. 5.42 ± 2.46 μm, P = 0.293) were similar in both groups. The systemic disease group had significantly higher levels of PWV (8.79 ± 1.21 vs. 7.88 ± 0.72 m/s, P = 0.036) compared to those with exclusive mucocutaneous manifestations. BD patients with vascular involvement had similar PWV and echo-tracking parameters compared to those without vascular involvement (P > 0.05), but had higher total and LDL cholesterol levels (P = 0.019 and P = 0.012, respectively). The multivariate linear regression analysis identified triglycerides as the most important factor in increasing PWV levels (P = 0.001) in BD.
PWV is more useful than carotid ultrasound in detecting structural and functional vascular damage in BD and emphasizes the role of the disease itself in promoting these alterations. Our findings also reinforce the need for rigorous control of all risk factors in BD, particularly lipoproteins.
使用颈动脉-股动脉脉搏波速度(PWV)和回声跟踪系统评估白塞病(BD)患者血管的结构和功能特性。
选择无传统心血管危险因素的 BD 患者。所有 BD 患者均进行 PWV 和颈动脉超声检查。根据是否存在全身(血管和/或眼部和/或中枢神经系统受累)和血管受累,将 BD 患者分为两组。选择年龄和性别匹配且具有相同排除标准的健康对照者作为对照组。
共 23 例 BD 患者(平均年龄 35.0 ± 7.6 岁)的 PWV 水平明显高于对照组(8.48 ± 1.14 比 7.53 ± 1.40 m/s,P = 0.017)。内膜-中层厚度(594.87 ± 138.61 比 561.08 ± 134.26 μm,P = 0.371)、舒张直径(6383.78 ± 960.49 比 6447.65 ± 1159.73 μm,P = 0.840)、扩张度(401.95 ± 117.72 比 337.91 ± 175.36 μm,P = 0.225)和相对扩张度(6.26 ± 2.83 比 5.42 ± 2.46 μm,P = 0.293)在两组间相似。与仅有黏膜皮肤表现的患者相比,全身疾病组的 PWV 水平明显更高(8.79 ± 1.21 比 7.88 ± 0.72 m/s,P = 0.036)。有血管受累的 BD 患者与无血管受累的患者相比,PWV 和回声跟踪参数相似(P > 0.05),但总胆固醇和 LDL 胆固醇水平更高(P = 0.019 和 P = 0.012)。多元线性回归分析发现,在 BD 患者中,三酰甘油是导致 PWV 水平升高的最重要因素(P = 0.001)。
与颈动脉超声相比,PWV 更能检测 BD 患者血管的结构和功能损伤,强调疾病本身在促进这些改变中的作用。我们的研究结果还强调了在 BD 中需要严格控制所有危险因素,特别是脂蛋白。