单中心心血管白塞氏病32例临床分析  

Analysis of 32 Behcet's disease patients with cardiovascular disorder in a single center

作　　者：许铭 宋来春 王波[1] 陶凉 金晶[1] XU Ming;SONG Lai-chun;WANG Bo;TAO Liang;JIN Jing(Department of Cardiac Surgery, Wuhan Asia Heart Hospital Affiliated Wuhan University o f Science and Technology, Wuhan 430022, China)

机构地区：[1]武汉科技大学附属武汉亚洲心脏病医院心外科,湖北省武汉市430022

出　　处：《中国心血管病研究》2019年第9期841-843,共3页Chinese Journal of Cardiovascular Research

基　　金：湖北省卫生计生科研基金(WJ2018H0100);武汉市卫生计生科研基金(WX17B19);2018武汉市中青年骨干人才资助.

摘　　要：目的总结心血管白塞氏病的发病特点、心血管损害特征及治疗效果,为临床诊治提供经验。方法回顾性分析武汉亚洲心脏病医院2002年至2018年收治的32例心血管白塞氏病的临床资料,男性21例,女性11例,平均年龄(42.3±7.5)岁,重点分析累及病变、治疗方式及预后。结果32例患者中明确诊断27例,疑诊5例,术前表现为腹主动脉瘤2例,单纯主动脉瓣损害15例(46.9%),单纯累及二尖瓣4例(12.5%),主动脉瓣合并二尖瓣病变共7例(21.9%),冠状动脉粥样硬化性心脏病4例。11例患者接受了16次外科手术治疗,其中8例瓣膜手术患者中有5例因瓣周漏行二次手术,有4例行带主动脉瓣人工血管升主动脉替换术(Bentall术)。手术患者中死亡4例,失访1例,存活6例。未手术的21例中,死亡7例,失访6例,存活8例。所有存活患者在随访中有85.7%(12/14)伴随严重并发症,包括反复发热、心功能衰竭、人工瓣瓣周漏、瓣周赘生物形成等。结论心血管白塞氏病最常累及主动脉瓣,其手术风险大,死亡率高,Bentall术可能是较好的术式,但总体远期预后较差。Objective To investigate the clinical characteristic and prognosis of Behcet's disease patients with cardiovascular disorder in a single center. Methods 32 hospitalized cases in Wuhan Asia Heart Hospital from Jan. 2002 to Dec. 2018 were included in the retrospectively study. 21 were male and the others were female. The average age was (42.3±7.5) years old. Results 27 cases had definite diagnosis, 5 cases had suspected diagnosis. Among 32 patients, there were 2 abdominal aortic aneurysm, 15 aortic valve damage (46.9%), 4 mitral valve damage (12.5%), 7 aortic and mitral valve damage (21.9%), 4 coronary artery diseases. There were 11 patients underwent surgical treatment. Eight cases underwent 13 heart valve surgery (5 second operations because of perivalvular leakage). 3 underwent Bentall's procedure. 6 survived from operation and 4 died, 1 case lost follow-up. Among the cases without operation, 8 survived, 6 lost follow-up and 7died. During follow-up, 85.7% of the survived patients were lived with serious complications, including repeated fever, heart failure, perivalvular leakage, vegetations formation, et al. Conclusions Cardiovascular behcet's disease most often affect aortic valve, the operation of which had great risk and mortality. Bentall's procedure may be a better choice. However the long-term prognosis is still poor.

关 键 词：白塞病 心血管病 手术 预后 

分 类 号：R654.2[医药卫生—外科学]