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贝赫切特病作为脑静脉窦血栓形成的致病因素:来自 VENOST 研究的数据的亚组分析。

Behçet's disease as a causative factor of cerebral venous sinus thrombosis: subgroup analysis of data from the VENOST study.

机构信息

School of Medicine, Department of Neurology, Istanbul Cerrahpasa University, Istanbul.

School of Medicine, Department of Neurology, Marmara University, Istanbul.

出版信息

Rheumatology (Oxford). 2019 Apr 1;58(4):600-608. doi: 10.1093/rheumatology/key153.

Abstract

OBJECTIVE

This study was performed to determine the rate of cerebral venous sinus thrombosis (CVST) among cases of Behçet's disease (BD) included in a multicentre study of cerebral venous sinus thrombosis (VENOST).

METHODS

VENOST was a retrospective and prospective national multicentre observational study that included 1144 patients with CVST. The patients were classified according to aetiologic factors, time of CVST symptom onset, sinus involvement, treatment approach and prognosis.

RESULTS

BD was shown to be a causative factor of CVST in 108 (9.4%) of 1144 patients. The mean age of patients in the BD group was 35.27 years and 68.5% were men, whereas in the non-BD CVST group, the mean age was 40.57 years and 28.3% were men (P < 0.001). Among the aetiologic factors for patients aged 18-36 years, BD was predominant for men, and puerperium was predominant for women. The onset of symptoms in the BD group was consistent with the subacute form. The transverse sinuses were the most common sites of thrombosis, followed by the superior sagittal sinuses. The most common symptom was headache (96.2%), followed by visual field defects (38%).

CONCLUSIONS

BD was found in 9.4% of patients in our VENOST series. Patients with BD were younger and showed a male predominance. The functional outcome of CVST in patients with BD was good; only 12% of patients presenting with cranial nerve involvement and altered consciousness at the beginning had a poor outcome (modified Rankin Score ⩾2).

摘要

目的

本研究旨在确定多中心脑静脉窦血栓形成(VENOST)研究中包括的贝赫切特病(BD)病例中脑静脉窦血栓形成(CVST)的发生率。

方法

VENOST 是一项回顾性和前瞻性的全国多中心观察性研究,共纳入 1144 例 CVST 患者。根据病因、CVST 症状发作时间、窦受累、治疗方法和预后对患者进行分类。

结果

BD 是 1144 例患者中 108 例(9.4%)CVST 的病因。BD 组患者的平均年龄为 35.27 岁,68.5%为男性,而非 BD CVST 组患者的平均年龄为 40.57 岁,28.3%为男性(P<0.001)。在 18-36 岁患者的病因中,BD 以男性为主,产褥期以女性为主。BD 组的症状发作符合亚急性形式。血栓形成最常见的部位是横窦,其次是上矢状窦。最常见的症状是头痛(96.2%),其次是视野缺损(38%)。

结论

在我们的 VENOST 系列中,9.4%的患者发现了 BD。BD 患者年龄较小,以男性为主。BD 患者 CVST 的功能预后良好;仅有 12%的患者在发病时伴有颅神经受累和意识改变,预后不良(改良 Rankin 评分 ⩾2)。

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