Torgutalp Murat, Sahin Eroglu Didem, Sezer Serdar, Yayla Mucteba E, Karatas Gokturk, Uslu Yurteri Emine, Turgay Tahsin M, Kinikli Gulay, Ates Askin
Department of Gastroenterology, Infectiology and Rheumatology (including Nutrition Medicine), Charité - Universitätsmedizin Berlin, Berlin, Germany; Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Ankara University, Ankara, Turkey.
Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Ankara University, Ankara, Turkey.
Joint Bone Spine. 2022 Mar;89(2):105277. doi: 10.1016/j.jbspin.2021.105277. Epub 2021 Sep 15.
To describe demographic and clinical characteristics of vascular involvement in patients with Behçet's syndrome (BS) and to evaluate associations with such involvement.
We retrospectively evaluated records of 2118 BS patients. In total, 460 patients diagnosed with superficial thrombophlebitis (ST) and/or major vascular events (venous and/or arterial involvements) were included in current analysis. Isolated ST with no accompanying deep venous thrombosis might be accepted as part of skin involvement; therefore, we defined two different outcomes for vascular involvement ("any vascular event" and "major vascular events") and performed univariable and multivariable logistic regression to assess factors associated with these outcome variables.
Overall, 68 (14.8%) patients had isolated ST, and 392 (85.2%) had major vascular events. The mean age of vascular BS was 33.8 (SD: 10.5) years and median follow-up was 13.9 (Q1-Q3: 8.3-22.9) years. The primary sites of major vascular events were deep venous thrombosis (n=358, 77.8%), pulmonary arterial involvement (n=66, 14.3%), extrapulmonary arterial involvement (n=52, 11.3%), and intracardiac thrombosis (n=14, 3.0%), respectively. Male sex was significantly associated with a higher risk for both outcome variables. When it was added to analysis, ST itself was the strongest explanatory variable that was associated with major vascular events in all multivariable models (ORs=11.9, 12.0, 13.0, and 18.9). While HLA-B51 was significantly associated with any vascular event, there was no similar observation for major vascular events.
Male sex is a well-known risk factor for major vascular events in BS, but our study established that presence of ST was the strongest risk factor.
描述白塞病（BS）患者血管受累的人口统计学和临床特征，并评估与这种受累情况的相关性。
我们回顾性评估了2118例BS患者的记录。共有460例被诊断为浅表血栓性静脉炎（ST）和/或主要血管事件（静脉和/或动脉受累）的患者纳入了当前分析。无伴随深静脉血栓形成的孤立ST可能被视为皮肤受累的一部分；因此，我们定义了血管受累的两种不同结局（“任何血管事件”和“主要血管事件”），并进行单变量和多变量逻辑回归以评估与这些结局变量相关的因素。
总体而言，68例（14.8%）患者有孤立ST，392例（85.2%）有主要血管事件。血管性BS的平均年龄为33.8（标准差：10.5）岁，中位随访时间为13.9（第一四分位数-第三四分位数：8.3-22.9）年。主要血管事件的主要部位分别为深静脉血栓形成（n=358，77.8%）、肺动脉受累（n=66，14.3%）、肺外动脉受累（n=52，11.3%）和心内血栓形成（n=14，3.0%）。男性与这两种结局变量的较高风险均显著相关。当将ST本身纳入分析时，它是所有多变量模型中与主要血管事件相关的最强解释变量（比值比分别为11.9、12.0、13.0和18.9）。虽然HLA-B51与任何血管事件显著相关，但在主要血管事件方面未观察到类似情况。
男性是BS中主要血管事件的一个众所周知的危险因素，但我们的研究表明ST的存在是最强的危险因素。
