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1、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
2、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 Secon
3、daryheartvalvediseasesbroughtonbytheconnetivetissuedisease:clinicalanalysisof18patients WANGRong-hui,CHENLi-xin,DONGTai-ming (DepartmentofInternalMedicine,GuzhenHospitalofZhongshanCity,Zhongshan,Guangdong528421,China;CardiovascularInstituteofGuangdongPeople'sHospita
4、l,Guangzhou,Guangdong510080,China) Abstract:ObjectiveToanalyzeandsummarizetheclinicalfeaturesofsecondaryheartvalvediseasesbroughtonbytheconnetivetissuedisease(CTD).Methods18patientsprovenwithCTD,including5malepatientswithBehcet'sdisease,aged(30±8.60)yearsold;5
5、patientswithrheumatoidarthritis,1maleand4females,aged(55.4±11.93)yearsold;6patientswithsystemiclupuserythematosus(SLE),2malesand4females,aged(30.2±27.56)yearsold;1malepatientwithanklylosingspondylitis,aged25yearsold;and1femalepatientwithdermatomyositis,a
6、ged27yearsold.All18patientssufferedwithheartvalveinjuriesprovenbyphysicalexamination,chestX-rayandtransthoraciccolourdopplerechocardiography,ultrasoundandaretrospectiveanalysisofheartvalveinjurywereperformed.ResultsWefoundthatallofthe5patientswithBehcet'sdiseasesuffer
7、edwithaorticincompetenceandpartofthemwithmitralincompetence,5patientswithrheumatoidarthritisand6patientswithSLEhadaorticandmitralincompetenceormitralstenosis,theankylosingspondylitisanddermatomyosispatienthasmitralincompetenceandaorticstenosis,allthese18casesdidnotsuf
8、feredwithtricuspiddisease.ConclusionPatientssufferwithCTDalwaysassociatedwithheartvalveinjuryandneedtobedifferentiallydiagno