Clinical Analysis Of 195 Cases Of Behcet's Disease

Objective:The clinical data of Behcet's disease(BD)in our hospital were summarized and analyzed to discover its clinical features,so as to improve the understanding of BD and reduce missed diagnosis,misdiagnosis,mistreatment and delay treatment.Methods:The medical records of 195 patients who were hospitalized in our hospital from January 2012 to November 2018 and diagnosed as BD were collected.Their clinical manifestations,laboratory examinations,imaging and gastrointestinal endoscopy were retrospectively analyzed.Results:Among the 195 patients,86(44.1%)were males and 109(55.9%)were females.The males to females ratio were 1:1.27.The age was(38.24±13.10)years,and the course of disease was(4.77±5.50)years.Clinical manifestations were oral aphthosis(100%),skin manifestations(65.6%),genital aphthosis(64.6%),fever(30.8%),Joint manifestations(28.2%),ocular manifestations(22.6%),gastrointestinal manifestations(13.8%),vascular involvement(7.2%),neurological manifestations(5.6%),cardiac manifestations(3.6%),hematological system manifestations(2.6%),Pulmonary manifestations(1.5%),Renal manifestations(1.5%),orchitis and epididymitis(1.5%).Patients with ocular,gastrointestinal,vascular,and cardiac manifestations are more severe,which can seriously affect the quality of life and even threaten their lives.Among them,uveitis(10/44,22.7%)was the most common ocular lesion,and severe cases were blind(2/44,4.5%).The most common clinical manifestations of gastrointestinal lesions were abdominal pain(15/27,55.6%),Ulcerative lesions(15/18,83.3%)were the main manifestations of endoscopy,Intestinal inflammatory lesions(7/12,58.3%)were the most common imaging manifestations.Intestinal stenosis/obstruction(2/27,7.4%),intestinal fistula(1/27,3.7%)and intestinal perforation(1/27,3.7%)could occur in severe cases.Deep venous thrombosis(9/14,64.3%)was the most common vascular lesion,followed by arterial stenosis(5/14,35.7%)and aneurysm(4/14,28.6%),A patient may have both arteries and veins involved(4/14,28.6%).cardiac involvement is mainly caused by heart valve damage(5/7,71.4%),which is characterized by valvular insufficiency.Some severe patients needed surgical treatment.5 cases of gastrointestinal surgery(intestinal resection,enterostomy,perianal abscess excision,anal fistula excision),4 cases of cardiac surgery(heart valve replacement,pacemaker implantation),4 cases of vascular surgery(pseudoaneurysm excision,arterial stent implantation,artificial vascular replacement,Intravenous thrombolysis and thrombosuction),2 cases of ocular surgery(pterygium excision,iridectomy).In laboratory tests,45.8%(22/48)of anti-endothelial cell antibodies(AECA)were positive.Conclusion: Behcet's disease tended to occur in young and middle-aged people,and women are slightly more than men.The clinical manifestations of BD are multi-system and multi-organ involvement.Oral aphthosis are the most common clinical manifestations,followed by skin lesions and genital aphthosis.Those with ocular,gastrointestinal,vascular and cardiac involvement often in serious condition,clinicians should be familiar with their clinical features to avoid misdiagnosis and missed diagnosis.Laboratory examination may be positive for AECA,which has certain reference value for diagnosis.