累及心脏瓣膜的白塞氏病的临床分析  

Clinical study of Behcet's disease with cardiac valve involvemont

作　　者：张雪冬[1] 万瑾[1] 朱光发[1] 

机构地区：[1]北京首都医科大学附属北京安贞医院-北京市心肺血管疾病研究所感染科,100029

出　　处：《心肺血管病杂志》2017年第11期905-908,共4页Journal of Cardiovascular and Pulmonary Diseases

摘　　要：目的:探讨累及心脏瓣膜的白塞氏病的临床特点方法:回顾性分析北京安贞医院,10年间收治的以心脏瓣膜为主要病变的白塞病35例的病例资料。结果:患者中男性29例,女性6例,发病年龄在21~57岁之间。患者中23例(65.7%)累及主动脉瓣;术前明确诊断患者中14例行一次手术,4例行二次手术,1例未手术,死亡2例,第一次手术后4例(22.2%)发生瓣周漏;术前未明确诊断患者4例行1次手术,8例行2次手术,4例行3次手术,死亡3例,第一次手术后16例(100%)发生瓣周漏。发生瓣周漏(PL)患者中激素治疗8例,未进行激素治疗的21例;未发生PL的患者激素治疗25例,未进行激素治疗0例。结论:累及心脏瓣膜的白塞氏病的治疗关键在于术前明确诊断,进行针对性治疗。白塞氏病患者围手术期未进行系统的内科治疗就进行的手术,手术后容易导致发生严重的瓣周漏,危及患者的生命。激素治疗可以有效地减少术后瓣周漏的发生。Objective： Discuss the clinical characteristics of Cardiovascular Behcet＇ s disease with car- diac valve. Methods： Clinical data of 35 patients with Cardiovascular Behcet＇ s disease with cardiac valve ad- mitted to Peking Anzhen Hospital in the last 10 years was retrospectively analyzed. Results： Patients with male 29 cases, female 6 cases, onset age between the ages of 21 to 57. Patients with 23 （65. 7% ）cases involving the aortic valve; In patients with preoperative diagnosis of 14 cases once operation, 4 （22. 2% ）cases twice opera- tion, 1 case without operation, 2 cases died, 4 cases happen perivalvular leakage after the first operation;Pre- operative uncertain diagnosis of 4 cases once operation, 8 cases twice operation ,4 case three times operation, 3 cases died, 16 （100%）cases happen perivalvular leakage after the first operation; perivalvular leakage of hor- mone therapy in patients with 8 cases, 21 cases not on hormone therapy;pefivalvular leakage not occurring in 25 patients with hormone therapy is not 0 of hormone therapy on patients. Conclusion： The mostly point of the pa- tients of Cardiovascular Behcet＇ s disease with cardiac valve is diagnose definitudly before the operation, and treated in evidence. It is happened perivalvular leakage easily after the operation without system medical treated and dangered the life of the patients. The treatment of hormone can efficiencily reduce the perivalvular leakage after operation.

关 键 词：白塞氏病 心脏瓣膜 瓣周漏 

分 类 号：R54[医药卫生—心血管疾病]