18例结缔组织病心脏瓣膜病变临床分析

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。

Secondary heart valve diseases brought on by the connetive tissue disease:clinical analysis of 18 patients

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 Behcet's 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 Behcet's 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 ankylosing spondylitis and dermatomyosis patient has mitral incompetence and aortic stenosis,all these 18 cases did not suffered with tricuspid disease. Conclusion Patients suffer with CTD always associated with heart valve injury and need to be differentially diagnosed with rheumatic heart valve disease,that is very important to guide clinical treatment.