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[原发性干燥综合征的超声心动图表现]

[Echocardiographic findings in primary Sjögren syndrome].

作者信息

Espinola Zavaleta N, Morales Blanhir J, de Witt García M, Romero Cárdenas A, Vargas Barrón J

机构信息

Instituto Nacional de Cardiología Ignacio Chávez, Departamento de Ecocardiografía, México, D.F.

出版信息

Arch Inst Cardiol Mex. 1997 Mar-Apr;67(2):114-25.

PMID:9412422
Abstract

Primary Sjögren's syndrome is an autoimmune disorder characterized by an increased cellular and humoral activity, which determines immune-complex deposition at multisystemic level. The main morphologic and functional alterations associated with this syndrome at cardiovascular level have been described only in isolated cases. In this paper, 23 patients with primary Sjögren's syndrome were studied by transthoracic echocardiography. The aim of this study was to determine the relationship between the duration of the syndrome, sex and age with the type of cardiovascular abnormalities. All patients were women with mean age of 58 years (range from 39 to 76 years). The longest disease duration was 20 years and the shortest, 2 years. The main alterations were localized at valve level and are characterized by two patterns of thickening: 1) the first one involves the whole extension of one or more leaflets, 2) the other one is nodular and involves only the edge of one or more leaflets. The abnormal valves were mitral, aortic and tricuspid, but none of them showed a significant dysfunction. We did not find any association between the type of valve abnormalities and age or disease duration. It was concluded that the wide variety of morphologic abnormalities at valvular level were related with degenerative factors associated with the age in some cases, but in others its development probably depends on immunopathologic features of the primary Sjögren's syndrome. It must be proved in future studies whether the affected tissue can be assessed by immunohistochemical tests.

摘要

原发性干燥综合征是一种自身免疫性疾病,其特征为细胞和体液活性增加,这决定了免疫复合物在多系统水平的沉积。仅在个别病例中描述了与该综合征相关的心血管水平的主要形态学和功能改变。本文通过经胸超声心动图对23例原发性干燥综合征患者进行了研究。本研究的目的是确定综合征的持续时间、性别和年龄与心血管异常类型之间的关系。所有患者均为女性,平均年龄58岁(范围39至76岁)。疾病最长持续时间为20年,最短为2年。主要改变位于瓣膜水平,其特征为两种增厚模式:1)第一种累及一个或多个瓣叶的整个范围,2)另一种为结节状,仅累及一个或多个瓣叶的边缘。异常瓣膜为二尖瓣、主动脉瓣和三尖瓣,但均未显示明显功能障碍。我们未发现瓣膜异常类型与年龄或疾病持续时间之间存在任何关联。得出的结论是,瓣膜水平的多种形态学异常在某些情况下与年龄相关的退行性因素有关,但在其他情况下,其发展可能取决于原发性干燥综合征的免疫病理特征。未来研究必须证明受影响的组织是否可通过免疫组织化学检测进行评估。

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