系统性红斑狼疮相关性眼部损害  

Ocular manifestations of systemic lupus erythematosus

作　　者：雷小姝[1] 李守新[1] 胡绍先[1] 涂巍[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院风湿免疫科,武汉430030

出　　处：《中华风湿病学杂志》2009年第12期837-840,共4页Chinese Journal of Rheumatology

摘　　要：目的了解系统性红斑狼疮（SLE）相关性眼部损害的发生率、表现形式以及与SLE疾病活动性、其他系统损害和自身抗体的相关性。方法回顾性分析我科2008年1月至12月期间住院SLE患者152例，其中有眼部损害者34例为实验组，另选取其中无眼部损害的SLE48例为对照组，详细记录患者主要临床症状、器官受累情况、眼部体征、外周血自身抗体以及SLE疾病活动指数（SLEDAI）。结果152例患者中34例出现眼部损害，发生率22．4％。其中女性31例，平均年龄35．6岁，平均SLEDAI评分（18±7）分。16例（47％）患者眼部损害出现在SLE病程1年以内。最常见的眼部表现是眼底病变23例（68％），其中13例视网膜病变（11例双眼，2例单眼），9例视网膜血管病变（7例双眼微血管病变，2例单眼视网膜中央动静脉血管栓塞），1例双眼脉络膜萎缩，其他眼部表现包括8例Schirmer’s试验异常（6例双眼，2例单眼），1例视神经病变（单眼），4例视野缺损（2例双眼，2例单眼），1例巩膜炎（双眼），1例虹膜睫状体炎（单眼），1例青光眼（单眼），4例角膜炎（3例双眼，1例单眼），3例结膜炎（2例双眼，1例单眼），1例睑缘炎（双眼）。实验组与对照组比较，前者皮疹发生率更高，其他系统损害、SLEDAI及自身抗体检测差异均无统计学意义。免疫抑制剂治疗后27例（79％）眼部症状或体征好转。结论SLE患者眼部病变并不少见，其表现形式多种多样，重者视力下降甚至失明。SLE相关性眼部损害可出现在疾病早期，甚至先于疾病出现，免疫抑制剂治疗可能有效改善眼部症状。Objective To determine the prevalence and spectrum of ocular manifestations of systemic lupus erythematosus （SLE） and to examine the correlation between the ocular manifestations and disease activity, other organ involvement and the presence of circulating autoantibodies. Methods 152 patients at Tongji Hospital from January 2008 to December 2008 were included in this retrospective study. Thirty-four SLE patients with positive ocular manifestations and 48 SLE patients with negative ocular manifestations were included in this study. All patients were comprehensively evaluated including ophthalmological examination, general lesions, and the circulating autoantibodies , crythrocyte sedimentation rate （ESR） were measured and their SLE disease activity index （SLEDAI） were measured. Results 152 patients were analyzed. Thirty-four patients complained of ophthalmologic disturbances （22%）, of which 31 patients were female, the mean age was 35.6 years and the mean SLEDAI was 17＋8. Sixteen patients （47%） had SLE for less than one year. ＂Ocular fundus complications＂ were the most common symptoms （23 patients）. Changes in retina were found in 13 patients （11 bilateral, 2 unilateral）. Nine patients （7 bilateral microangiopathy, 2 unilateral vasoocclusive retinopathy） had retinal vascular lesions. One patient had choroid coat atrophy. Eight patients （4 unilateral, one bilateral ） had abnormal Schirmer＇s test. One patient had unilateral optic neuropathy. 4 patients had visual field defects （2 bilateral, 2 unilateral）. Sclera changes was detected in 1 patient. One patient had unilateral iridocyclitis. One patient had glaucoma. Corneal involvement was found in 4 patients （3 bilateral, 1 unilateral）. Conjunctivitis was found in 3 patients （2 bilateral, 1 unilateral）. One patient had blear-eye. Compared between the two groups, there was no significant difference in clinical features, circulating autoantibodies, ESR and SLEDAI except skin lesions. Ocular involvement of lupus pati

关 键 词：红斑狼疮 系统性 眼疾病 自身抗体 

分 类 号：R593.241[医药卫生—内科学] R135.92[医药卫生—临床医学]