Clinical features of Chinese patients with Behcet's disease
Clinical features of Chinese patients with Behcet's disease
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中国白塞病患者的临床特征
DOI：
10.1016/j.ophtha.2007.04.056
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发表时间：
2008-02-01
期刊：
影响因子：
13.7
通讯作者：
Kijlstra, Aize
中科院分区：
文献类型：
--
作者：
Yang, Peizeng;Fang, Wang;Kijlstra, Aize
目的：探讨白塞氏病的临床特点。设计：回顾性非比较性病例系列。参与者：从1995年8月到2006年6月，对437名白塞氏病患者的775只眼睛进行了初步检查。方法：回顾中山大学葡萄膜炎研究中心连续收治的所有Behcet患者的病史、人口学参数和临床表现。在某些病例中进行了激光耀斑细胞光度测定（LFCM）、眼底荧光素血管造影（FFA）、光学相干断层扫描（OCT）、超声生物显微镜（UBM）和b超扫描。大多数患者采用免疫抑制剂联合口服皮质类固醇治疗。主要结果测量：患者人口统计学、临床表现和辅助检查结果。结果：437例患者被诊断为白塞病。男319例，女118例。全葡萄膜炎是两性中最常见的葡萄膜炎类型，尽管前葡萄膜炎在女性中更为常见。视网膜血管炎、玻璃体炎和视网膜炎是这些患者最常见的眼部表现。白内障和黄斑水肿是最常见的并发症。口腔溃疡是最常见的眼外表现，其次是皮肤病变和生殖器溃疡。FFA、OCT、b超、LFCM、UBM结果与临床观察基本一致或相当。在最后一次就诊时，86.2%的患者葡萄膜炎得到了很好的控制。然而，尽管进行了积极的治疗，仍有20.4%的眼睛在法律上失明。Kaplan-Meier分析估计，男性和女性在5岁和10岁时失去有用视力的风险（0.05）分别为29%对6%和65%对33%。结论：白塞病患者以非肉芽肿性葡萄膜炎为主，常伴有口腔溃疡和皮肤病变。眼底荧光素血管造影、b超、LFCM、UBM和OCT可以提供很多关于白塞病病理生理特征的信息。皮质类固醇联合其他免疫抑制剂对大多数白塞病患者有效。男性的病程更严重，失去视力的风险也比女性高。
Purpose: To characterize the clinical features of Behcet's disease in Chinese patients.Design: Retrospective noncomparative case series.Participants: Seven hundred seventy-five eyes of 437 patients with Behcet's disease initially examined from August, 1995, through June, 2006.Methods: The history, demographic parameters, and clinical findings of all consecutive Behcet's patients referred to the uveitis study center of Sun Yat-sen University were reviewed. Laser flare-cell photometry (LFCM), fundus fluorescein angiography (FFA), optical coherence tomography (OCT), ultrasound biomicroscopy (UBM), and B-scan ultrasonography were performed in certain cases. Most patients were treated by immunosuppressive agents combined with oral corticosteroids.Main Outcome Measures: Patient demographics, clinical presentation, and auxiliary examination findings.Results: Four hundred thirty-seven patients were diagnosed with Behcet's disease. There were 319 male and 118 female patients. Panuveitis was the most common type of uveitis in both genders, although anterior uveitis was seen more frequently in females. Retinal vasculitis, vitreitis, and retinitis were the most common ocular manifestations in these patients. Cataract and macular edema were the most common complications. Oral aphthae were the most frequent extraocular manifestation, followed by dermatologic lesions, and genital ulcers. The results of FFA, OCT, B-scan ultrasonography, LFCM, and UBM generally were in accordance with or comparable with clinical observations. At the final visit, uveitis was well controlled in 86.2% of patients. However, 20.4% of eyes became legally blind despite aggressive treatment. Kaplan-Meier analysis estimated the risk of losing useful vision (0.05) at 5 and 10 years for males and females as 29% versus 6% and 65% versus 33%, respectively.Conclusions: Behcet's disease in Chinese patients mainly manifests as nongranulomatous uveitis frequently associated with oral aphthae and dermatologic lesions. Fundus fluorescein angiography, B-scan ultrasonography, LFCM, UBM, and OCT may provide much information about pathophysiologic hallmarks of Behcet's disease. A combination of corticosteroids with other immunosuppressive agents is effective for most patients with Behcet's disease. Males had a more severe course and were at higher risk for losing vision than females.