Le Thi Huong D u, Wechsler B, Kahn J C, Benhamou E, Cajfinger F, Le Hoang P, Godeau P
Service de Médecine interne, hôpital de la Pitié, Paris.
Arch Mal Coeur Vaiss. 1987 Oct;80(11):1663-7.
A case of myocardial infarction in a 23-year old male patient with Behçet's disease is reported. The infarction occurred 4 years after the onset of the disease, which had been marked by recurrent venous thrombosis. Coronary arteriography showed stenosis of the anterior interventricular artery and occlusion of the first diagonal artery; the other coronary vessels were normal. A search for vascular risk factors, including haemostasis, was undertaken, yielding only moderate cigarette-smoking. About 10 cases of myocardial infarction associated with Behçet's disease have been reported. They concerned young, usually male subjects. Infarction usually occurred late in the course of the disease, and vascular risk factors were seldom elicited. The leukocytoclastic vasculitis of Behçet's disease alone may be responsible for stenosis, thrombosis and false arterial aneurysms, as shown by anatomical studies. The physiopathological mechanisms involved (reduction of endothelial or systemic fibrinolytic activity, rise in fibrinogen and factor VIII) are still unclear; we believe that these abnormalities are inconstant. Behçet's disease may be regarded as a possible cause of myocardial infarction in young subjects.
报道了1例患有白塞病的23岁男性患者发生心肌梗死的病例。心肌梗死发生在疾病发作4年后,该病以反复静脉血栓形成为特征。冠状动脉造影显示前室间动脉狭窄和第一对角支动脉闭塞;其他冠状动脉血管正常。对包括止血在内的血管危险因素进行了排查,结果仅发现患者有中度吸烟情况。此前已报道过约10例与白塞病相关的心肌梗死病例。这些病例涉及的通常是年轻男性患者。心肌梗死通常发生在疾病病程后期,且很少能查出血管危险因素。解剖学研究表明,仅白塞病的白细胞破碎性血管炎就可能导致血管狭窄、血栓形成和假性动脉瘤。其中涉及的生理病理机制(内皮或全身纤溶活性降低、纤维蛋白原和因子VIII升高)仍不清楚;我们认为这些异常情况并不常见。白塞病可被视为年轻患者心肌梗死的一个可能病因。