白塞病肺大血管受累13例临床及影像分析  

Involvement of large pulmonary vessels in Behcet's disease:the clinical imaging features of 13 cases

作　　者：窦丽阳[1] 施举红[2] 严晓伟[1] 陆慰萱[2] 

机构地区：[1]中国医学科学院北京协和医学院北京协和医院心内科,北京100730 [2]中国医学科学院北京协和医学院北京协和医院呼吸科,北京100730

出　　处：《中国实用内科杂志》2010年第2期137-139,共3页Chinese Journal of Practical Internal Medicine

摘　　要：目的分析白塞病(BD)合并肺大血管受累的临床特点。方法回顾分析1983年1月至2008年9月北京协和医院BD合并肺大血管受累患者的临床资料。结果BD患者共418例,其中肺部大血管受累共13例。13例肺部大血管受累患者平均年龄(37.5±12)岁,肺部临床表现为咯血10例(69.2%),呼吸困难8例(61.5%)。CT肺血管成像示肺动脉瘤形成7例(53.8%),单纯肺动脉(或静脉)闭塞6例(46.2%),肺血管内血栓形成6例(46.2%)。全部患者均采用激素合并免疫抑制剂治疗,其中5例进行激素冲击治疗;4例进行血管介入治疗。平均随访(3±1.6)年,随访率为92.3%;肺大血管受累患者的3年存活率为83.9%。结论BD累及肺部大血管临床表现多样;CT肺血管成像为诊断的主要检查。Objective To analyze the clinical characteristics of large pulmonary vessel involvement in Beheet＇s disease. Methods The clinical data of Beheet＇s disease patients with large pulmonary vessel involvement,who were treated in Peking Union Medical College Hospital from 1983 to 2008 ,were retrospectively analyzed. Results Thirteen patients had large pulmonary vessel involvement among a total of 418 patients with Behcet＇s disease. The 13 patients had a mean age of （ 37.5 ± 12 ） years old, with 10 （ 69. 2% ） having hemoptysis, 8 （61.5%） having dyspnea. Helical CT/CTPA showed that pulmonary vascular involvement included pulmonary arterial aneurysms （53.8%）, pulmonary artery occlusion （46. 2% ）, and pulmonary thrombi （46. 2% ）. All the 13 patients were treated with steroid and immunosuppressant; five received steroid pulse therapy;and four received vascular intervention therapy. The mean follow-up was （3 ± 1.6）years, with a follow-up rate of 92. 5%. The 3-year survival rate was 83.9% for the 13 patients. Conclusion The manifestation of pulmonary vascular involvement in Behcet＇s disease is various, and the diagnosis mainly depends on the manifestations of CT pulmonary angiography.

关 键 词：白塞病 肺血管 动脉瘤 免疫抑制 

分 类 号：R5[医药卫生—内科学]