多发性硬化患者眼病的临床分析和长期随访  

Analysis of Ocular Manifestation and Follow-up of 72 Patients with Multiple Sclerosis

作　　者：卢彦[1] 于强[1] 王梅[1] 夏朝霞[1] 胡玉新[1] 蓝育青[1] 

机构地区：[1]中山大学附属第二医院眼科,广东广州510120

出　　处：《中山大学学报（医学科学版）》2009年第A04期92-95,共4页Journal of Sun Yat-Sen University:Medical Sciences

摘　　要：【目的】探讨多发性硬化(MS)患者眼部发病的临床特征、诊治和病情转归。【方法】收集1998年1月至2007年12月期间我院多发性硬化住院患者72例,所有患者均符合Poser诊断标准,回顾性分析其全身和眼部发病特征及治疗情况,并随访追踪病情转归。【结果】多发性硬化多见20～50岁女性患者,25.4%(18/72)以眼部为首发症状,其中83.3%(15/18)表现视神经炎;12.5%(9/72)眼部和其他部位同时发病;尚有22.2%(16/72)在患病过程中出现视神经炎。视神经炎临床表现呈复发-缓解型,多次复发预后差。首次患病缓解后两年内75%～88%患者累及其他部位。首次患病核磁共振(MRI)联合视觉诱发电位(VEP)、脑干听觉诱发电位(BAEP)和体感诱发电位(SSEP)等检查,可提高MS的诊断率。急性期大剂量激素冲击治疗,或联合免疫球蛋白、免疫抑制剂,缓解期使用干扰素治疗能有效控制病情,减少复发,降低致盲率。【结论】MS患者眼部是常见受累器官之一,并常见首发眼部受累,多表现视神经炎。视神经炎临床表现呈复发-缓解型。首次患病行MRI联合VEP、BAEP、SSEP等检查,可提高MS的诊断率。联合使用激素、免疫球蛋白、免疫抑制剂、干扰素等能有效控制病情,减少复发率,降低致盲率。[Objective] To investigate multiple sclerosis （MS） with ocular manifestation, medical effect and results. [Methods] Collection of MS in-patient cases which were admitted from January 1998 to January 2007. Those systemic and ocular symptoms and therapy were analyzed retrospectively. [ Results ] MS was commonly seen in females aged from 20-50 years. 25.4%（18/72） of the MS patients initially broke out as ocular manifestation, and among them 83.3%（15/18） signed optic neuritis （ON）. 12.5%（9/72） of the MS cases broke out as systemic and ocular symptoms simultaneously. 22.2% （16/72） signed ON after the first attack. ON is characterized by recurrent relapses and followed by progressive deterioration and cognitive disability.75%- 88% MS cases broke out elsewhere after the first attack＇s relapse. The combination examinations of Magnetic resonance imaging （MRI）, VEP, BAEP and SSEP improved the diagnosis. Methylprednislone recombinant with interferon is beneficial in relapsing- remitting MS by reducing the frequency of relapses, slowing down the progression of physical disability. [ Conclusion ] MS is commonly initially broke out as ocular manifestation and signed ON. ON is characterized by recurrent relapses. The combination examinations of MRI, VEP , BAEP, and SSEP improved the diagnosis. Methylprednislone recombinant with interferon is beneficial in relapsing-remitting MS by reducing the frequency of relapses, slowing down the progression of physical disability.

关 键 词：多发性硬化 视神经炎 复发 

分 类 号：R77[医药卫生—眼科]