非感染性主动脉炎患者的单中心回顾性分析.

Objective To summarize the clinical characteristics of patients with non-infectious aortitis. Methods A retrospective analysis was made among 124 patients with non-infectious aortitis who were hospitalized in the Department of Cardiac Surgery and/or Rheumatology in Zhongshan Hospital Affiliated to Fudan University, from Jan., 2010 to Dec., 2017. Data were collected and analyzed, including preoperative general information, laboratory and radiologic examinations, and the clinical and surgical outcomes. Results Among the 124 patients, there were 45 patients of Takayasu arteritis (36.3%), 40 patients of isolated aortitis (32.3%), 37 patients of Behcet's disease (29.8%) and 2 patients of giant cell arteritis (1.6%). Moderate to severe aortic valve insufficiency was the most common (82 patients, 66.1%). Takayasu arteritis group was female dominant (3.5:1), while the onset age[(53.5+9.4) years] and diagnosis age[(55.0+9.3) years] in isolated aortitis group were much older (P<0.05). Ninety-seven patients (78.2%) received surgical treatment, of which 69 received primary operations, 28 received secondary operations. Forty-four cases (45.4%) received preoperative treatments of glucocorticoid and/or immunosuppressive agents. Aortic valve replacement (40.2%), Bentall's operation (23.7%) and coronary artery bypass grafting (11.3%) were the most common types of primary operations, resulting in significant decrease in systolic blood pressure[(119.2±38.1) mmHg vs. (108.9±37.9) mmHg, P<0.001]. Perivalvular aortic leakage (19 patients, 67.9%) was the main cause of secondary operations, of which Behcet's disease (13 patients, 68.4%) was common, and only 7 patients (36.8%) received glucocorticoid and/or immunosuppressive therapy prior to operations. Compared with 97 patients with surgery, the proportion of patients treated with glucocorticoids and/or immunosuppressive agents (63.0%) in 27 non-surgery patients was higher, the age of diagnosis (41.6 + 16.4 years) was younger, and women (74.1%) were more common. Of them, 17 patients (63.0%) postponed surgery after treatment with glucocorticoids and/or immunosuppressive agents. Conclusions Non-infectious aortitis was mainly seen in patients with primary systemic vasculitis such as Takayasu arteritis, isolated aortitis and Behcet's disease, with the most common lesion of aortic valve insufficiency. Medical treatment could help control inflammation and delay operation, and surgical treatment could help improve blood pressure. Patients with Behcet's disease without medical treatment would be more likely to suffer from perivalvular leakage after operation. [ABSTRACT FROM AUTHOR]