Division of Rheumatology, Department of Internal Medicine, Chungnam National University College of Medicine, Daejeon, Korea.
Yonsei Med J. 2024 Sep;65(9):493-500. doi: 10.3349/ymj.2023.0578.
Cardiovascular involvement in Behçet's disease (BD) is considerably related to morbidity and mortality. However, the cardiovascular manifestation is sometimes difficult to distinguish from those of other causes. The suspicion of BD and proper treatment is pivotal in the management of BD. Histology demonstrates perivasculitis. Neutrophil seems to play an important role in the inflammation of BD. It is thought that inflammation causes venous thrombosis and arterial aneurysm. Characteristically, BD involves both arteries and veins of variable size in any region. Venous thrombosis needs immunosuppression, and inferior vena cava thrombosis and Budd-Chiari syndrome require intensive immunosuppressive therapy. Arterial involvement causes aneurysm which usually is treated by surgical or endovascular intervention with immunosuppression. Pulmonary artery aneurysm and cardiac involvement require multimodal managements.
贝赫切特病(BD)的心血管受累与发病率和死亡率密切相关。然而,心血管表现有时难以与其他原因区分。怀疑 BD 并进行适当治疗对于 BD 的管理至关重要。组织学显示血管周围炎。中性粒细胞似乎在 BD 的炎症中起重要作用。据认为,炎症会导致静脉血栓形成和动脉动脉瘤。BD 的特征是在任何部位的大小不同的动脉和静脉都受到累及。静脉血栓形成需要免疫抑制治疗,而下腔静脉血栓形成和布加综合征需要强化免疫抑制治疗。动脉受累会导致动脉瘤,通常需要手术或血管内介入治疗以及免疫抑制治疗。肺动脉瘤和心脏受累需要多模式治疗。