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儿童白塞病的心血管合并症风险。

The risk of cardiovascular comorbidity in children with Behçet's disease.

机构信息

Department of Pediatric Rheumatology, Eskisehir Osmangazi University Medical Faculty, Eskisehir, Turkey.

Department of Pediatric Nephrology, Hacettepe University Medical Faculty, Ankara, Turkey.

出版信息

Rheumatology (Oxford). 2024 Sep 1;63(SI2):SI188-SI194. doi: 10.1093/rheumatology/kead505.

Abstract

OBJECTIVE

Patients with Behçet's disease (BD) may experience long-term morbidity caused by various forms of cardiovascular disease. This study aimed to assess the risk for cardiovascular comorbidity in paediatric BD patients with and without vascular involvement, independent of the contribution of traditional risk factors.

METHODS

Paediatric patients classified as having BD according to the 2015 Peadiatric BD (PEDBD) criteria were included in the study. Twenty-four-hour ambulatory blood pressure monitoring (ABPM), transthoracic echocardiography, and carotid intima-media thickness (cIMT) measurements were performed. Patients with an active disease or those who have other known risk factors for cardiovascular disease were not included in the study.

RESULTS

Thirty-one children and adolescents with paediatric BD (16 female, 51.6%; F/M: 1.06) were enrolled in the study. Among the BD patients, 10 patients (34.4%) had abnormal ABPM. Carotid IMT values, mean arterial pressure, systolic and diastolic blood pressure by ABPM and the prevalence of abnormal ABPM, non-dipping, and ambulatory hypertension were similar between patients with and without vascular involvement. The echocardiography measurements showed that BD patients with vascular involvement had a significantly higher velocity and velocity time integral of the left ventricle outflow tract, which may indicate increased stiffness of the aorta.

CONCLUSION

Paediatric BD patients with vascular involvement may tend to have more cardiovascular risk factors. However, cardiovascular assessment should be considered in all BD patients, regardless of the involved systems. We suggest that ABPM may accurately define hypertension and cardiovascular risk in BD.

摘要

目的

白塞病(BD)患者可能会因各种形式的心血管疾病而长期患病。本研究旨在评估有和无血管受累的儿科 BD 患者发生心血管合并症的风险,而不受传统危险因素的影响。

方法

根据 2015 年儿科 BD(PEDBD)标准分类为 BD 的儿科患者被纳入本研究。进行 24 小时动态血压监测(ABPM)、经胸超声心动图和颈动脉内膜中层厚度(cIMT)测量。患有活动期疾病或有其他已知心血管疾病危险因素的患者不包括在本研究中。

结果

研究纳入了 31 名儿科 BD 患儿(16 名女性,51.6%;F/M:1.06)。在 BD 患者中,有 10 名患者(34.4%)的 ABPM 异常。颈动脉 IMT 值、平均动脉压、ABPM 的收缩压和舒张压以及异常 ABPM、非杓型和动态高血压的发生率在有和无血管受累的患者之间相似。超声心动图检查结果显示,有血管受累的 BD 患者的左心室流出道速度和速度时间积分明显更高,这可能表明主动脉僵硬度增加。

结论

有血管受累的儿科 BD 患者可能更容易有更多的心血管危险因素。然而,无论受累系统如何,都应考虑对所有 BD 患者进行心血管评估。我们建议 ABPM 可能准确定义 BD 中的高血压和心血管风险。

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