超声心动图误诊白塞病的临床分析  

Clinical analysis of misdiagnosis of Behcet’s disease with echocardiography

作　　者：李嵘娟[1] 蒲利红[1] 王月丽[1] 宋砾[1] 谢谨捷[1] 朱恩军[2] 杨娅[1] LI Rongjuan;PU Lihong;WANG Yueli;SONG Li;XIE Jinjie;ZHU Enjun;YANG Ya(Department of Echocardiography,Beijing Anzhen Hospital Affiliated to Capital Medical University,Beijing 100029,China;Department of Cardiac Surgery,Beijing Anzhen Hospital Affiliated to Capital Medical University,Beijing 100029,China)

机构地区：[1]首都医科大学附属北京安贞医院超声心动图一部,北京100029 [2]首都医科大学附属北京安贞医院心外科,北京100029

出　　处：《中国医学影像技术》2019年第11期1648-1651,共4页Chinese Journal of Medical Imaging Technology

摘　　要：目的分析超声心动图将白塞病误诊为主动脉瓣感染性心内膜炎患者的声像图特征及误诊原因。方法回顾性分析我院临床诊断白塞病累及心血管系统患者资料,总结其临床及超声表现。结果 12例白塞病患者中,9例为心脏术前患者,3例为心脏术后患者。9例心脏术前患者均表现为重度主动脉瓣反流,其中3例合并主动脉瓣周脓肿、4例合并主动脉瓣赘生物形成、2例合并主动脉瓣周脓肿及赘生物形成;3例心脏术后患者表现为主动脉瓣人工瓣瓣周漏,其中1例主动脉瓣人工瓣赘生物形成、1例瓣周脓肿、1例人工瓣瓣周脓肿及赘生物形成。结论伴有赘生物、瓣周脓肿等声像图表现的白塞病合并主动脉瓣关闭不全单纯依靠超声诊断较为困难,如果患者合并口、眼、生殖器等特征性器官损害应提示心脏白塞病可能性。Objective To analyze the echocardiographic features of Behcet’s disease misdiagnosed as infective endocarditis and the causes of misdiagnosis. Methods Clinical data of patients with Behcet’s disease involving cardiovascular system were analyzed retrospectively and the clinical and echocardiographic features of these patients were summarized. Results Among the 12 patients with Behcet’s disease, 9 cases were preoperative cardiac surgery patients and 3 cases were postoperative cardiac surgery patients. All the 9 patients showed severe aortic regurgitation, including 3 cases with aortic perivalvular abscess, 4 cases with aortic valve vegetation, 2 cases with aortic perivalvular abscess and vegetation formation. Perivalvular leakage of aortic valve was found in 3 patients after cardiac surgery, including 1 case of aortic valve vegetation formation, 1 case of perivalvular abscess, 1 case of perivalvular abscess and vegetation formation. Conclusion It is difficult to diagnose Behcet’s disease combined with aortic valve insufficiency with vegetation-like mobile lesions, an echo-free space mimicking aortic root abscess. If the patients with history of recurrent oral aphthosis, genital aphthosis or ocular lesions, the possibility of cardiac Behcet’s disease should be suggested.

关 键 词：超声心动描记术 贝赫切特综合征 心内膜炎 细菌性 主动脉瓣关闭不全 

分 类 号：R542.5[医药卫生—心血管疾病] R540.45[医药卫生—内科学]