白塞病血管受累的临床特征及影响因素分析  

Analysis of clinical characteristics and influencing factors of vascular involvement in Behçet′s disease

作　　者：潘冬梅[1] 赵铖[1] 陈战瑞[1] 覃芳[1] 文静[1] 韦宛伶 曾雯 廖晓玲 董菲 雷玲[1] Pan Dongmei;Zhao Cheng;Chen Zhanrui;Qin Fang;Wen Jing;Wei Wanling;Zeng Wen;Liao Xiaoling;Dong Fei;Lei Ling(Department of Rheumatology and Immunology,the First Affiliated Hospital of Guangxi Medical University,Nanning 530021,China)

机构地区：[1]广西医科大学第一附属医院风湿免疫科,南宁530021

出　　处：《中华风湿病学杂志》2024年第8期566-570,共5页Chinese Journal of Rheumatology

基　　金：国家自然科学基金(82060300);广西医疗卫生适宜技术开发与推广应用项目(S2022075);广西卫生健康委自筹经费科研课题(Z20200656)。

摘　　要：目的分析白塞病(BD)血管受累的临床特征和发病及预后影响因素,为临床医生认识白塞病血管受累提供依据。方法收集2012年1月至2022年5月广西医科大学第一附属医院收治的220例白塞病患者的临床资料,比较有血管受累和无血管受累,病情好转组和进展组白塞病患者临床表现、实验室检查有无差异,统计学方法为二元logistic回归分析发病的影响因素。结果①220例白塞病患者中,平均年龄(36.5±15.3)岁,有血管病变的患者23例(10.5%),男性20例(87.0%)。②与无血管受累的白塞病患者相比,血管受累白塞病患者吸烟[6.1%(12/197)与34.8%(8/23),χ^(2)=17.19,P<0.001],心脏受累[1.5%(3/197)与13.0%(9/23),χ^(2)=6.42,P=0.011],CRP升高[56.3%(111/197)与78.3%(18/23),χ^(2)=4.08,P=0.043]的比例明显增高。③血管受累的白塞病患者中,11例(47.8%)有静脉病变,20例(87.0%)有动脉病变,其中8例(34.8%)患者同时有静脉和动脉受累。最常见的血管受累类型是动脉扩张型11例,主要以动脉瘤(10例)为主,下肢深静脉血栓形成7例。④23例血管受累白塞病平均随访18.3个月,16例(69.6%)病情好转稳定,7例(30.4%)病情进展,其中4例死亡(1例男性,3例女性)。有91.3%(21/23)的患者接受了糖皮质激素治疗;82.6%(19/23)的患者接受了免疫抑制剂治疗,其中65.2%(10/23)的患者接受了环磷酰胺治疗,43.5%的患者接受了沙利度胺治疗,分别有13%(3/23)的患者接受了环孢素和甲氨蝶呤治疗,有8.7%(2/23)的患者接受了吗替麦考酚酯治疗;有21.7%(5/23)的患者接受了抗凝剂的治疗,抗凝药物均为华法林或低分子肝素;有17.4%(4/23)的患者接受了生物制剂治疗;有43.5%(10/23)的患者接受了外科手术治疗。⑤二元logistic回归分析显示男性是白塞病血管受累发生的独立危险因素[OR值(95%CI)=5.70(1.60,20.90),P=0.009]。结论白塞病患者血管受累发生率10.5%,男性多见,动脉受累比静脉受累更多见,常见动脉瘤;临床�ObjectiveTo analyze the clinical characteristics and influencing factors of vascular involvement in Behçet′s Disease(BD)to improve and provideunderstanding of insights for clinicians to better understand this condition.MethodsClinical data from^(2)20 BD patients admitted to the First Affiliated Hospital of Guangxi Medical University from January 2012 to May 2022 were collected.Clinical manifestations and laboratory findings were compared between BD patients with and without vascular involvement,as well as between those with improved conditions and those with progressive conditions.Binary logistic regression was used to analyze the influencing factors.Results①The average age of the 220 BD patients was 36.5±15.3 years.Among them,23 patients(10.5%)had vascular involvement,including 20 males(87.0%).②Compared to BD patients without vascular involvement,those with vascular involvement had significantly higher rates of smoking[6.1%(12/197)vs.34.8%(8/23),χ^(2)=17.19,P<0.001],cardiac involvement[1.5%(3/197)vs.13.0%(9/23),χ^(2)=6.42,P=0.011],and elevated C-reactive protein(CRP)levels(78.3%vs.56.3%,χ^(2)=4.08,P=0.043).③Among BD patients with vascular involvement,11 cases(47.8%)had venous lesions,and 20 cases(87.0%)had arterial lesions,with 8 cases(34.8%)having both venous and arterial involvement.The most common type of vascular involvement was arterial dilatation(11 cases),mainly aneurysms(10 cases),and deep venous thrombosis of the lower extremities(7 cases).④The 23 BD patients with vascular involvement were followed up for an average of 18.3 months.Among them,16 patients(69.6%)showed stable improvement,while 7 patients(30.4%)experienced disease progression,including 4 deaths(1 male and 3 females).A total of 91.3%(21/23)of the patients received glucocorticoid therapy.Immunosuppressive therapy was administered to 82.6%(19/23)of the patients,with 65.2%(10/23)receiving with cyclophosphamide and 43.5%receiving with thalidomide.Additionally,13%(3/23)of the patients were treated with cyclosporine and methotrexate

关 键 词：贝赫切特综合征 血管受累 动脉 静脉 影响因素 

分 类 号：R597.9[医药卫生—内科学]