18例结缔组织病心脏瓣膜病变临床分析.docVIP

KKME---专业医学搜索引擎/ 18例结缔组织病心脏瓣膜病变临床分析 　　作者：王荣辉，陈立新，董太明 作者单位：(广东省中山市古镇医院内科，广东中山528421;广东省人民医院心血管病研究所，广东广州510080) 　　【摘要】 目的 分析和总结结缔组织病(CTD)心脏瓣膜损害的临床特点。方法 对18例确诊为CTD患者，其中白塞病5例，均为男性，年龄(30±8.60)岁，类风湿关节炎5例，男1例，女4例，年龄(55.4±11.93)岁，系统性红斑狼疮(SLE)6例，男2例，女4例，年龄(30.2±27.56)岁，强直性脊柱炎1例，男，25岁，皮肌炎1例，女，27岁，均经临床体检、胸部X线、经胸心脏彩色多普勒B超等检查确认有心脏瓣膜损害，对其瓣膜损害情况进行回顾性分析。结果 白塞病5例均有主动脉瓣关闭不全，部分合并有二尖瓣关闭不全，类风湿关节炎5例和系统性红斑狼疮6例均有主动脉瓣关闭不全和二尖瓣关闭不全或二尖瓣狭窄，主动脉瓣狭窄较少见。强直性脊柱炎和皮肌炎各有1例均有主动脉瓣狭窄或关闭不全和二尖瓣关闭不全，18例中未见有侵犯三尖瓣者。结论 CTD患者具有不同程度的心脏瓣膜损害，需与风湿性心脏瓣膜病相鉴别，对指导临床治疗有重要意义。 　　【关键词】 结缔组织疾病;心脏瓣膜疾病 　　Secondary heart valve diseases brought on by the connetive tissue disease: clinical analysis of 18 patients 　　WANG Rong-hui, CHEN Li-xin, DONG Tai-ming 　　( Department of Internal Medicine, Guzhen Hospital of Zhongshan City, Zhongshan, Guangdong 528421,China; Cardiovascular Institute of Guangdong Peoples Hospital, Guangzhou, Guangdong 510080, China) 　　Abstract: Objective To analyze and summarize the clinical features of secondary heart valve diseases brought on by the connetive tissue disease(CTD). Methods 18 patients proven with CTD, including 5 male patients with Behcets disease, aged (30±8.60) years old; 5 patients with rheumatoid arthritis, 1 male and 4 females, aged (55.4±11.93) years old; 6 patients with systemic lupus erythematosus (SLE), 2 males and 4 females, aged (30.2±27.56) years old; 1 male patient with anklylosing spondylitis, aged 25 years old; and 1 female patient with dermatomyositis, aged 27 years old. All 18 patients suffered with heart valve injuries proven by physical examination, chest X-ray and transthoracic colour doppler echocardiography, ultrasound and a retrospective analysis of heart valve injury were performed. Results We found that all of the 5 patients with Behcets disease suffered with aortic incompetence and part of them with mitral incompetence, 5 patients with rheumatoid arthritis and 6 patients with SLE had aortic and mitral incompetence or mitral stenosis, the ankylosi