混合型青光眼住院病人的致病机制构成分析  

The analysis of pathogenic mechanism in hospitalized patients with mixed glaucoma

作　　者：赵军[1] 成洪波[1] 黄丽娜[1] 罗润来[1] 

机构地区：[1]深圳市眼科医院暨南大学附属深圳眼科医院,深圳518040

出　　处：《中国实用眼科杂志》2010年第8期884-887,共4页Chinese Journal of Practical Ophthalmology

摘　　要：目的 分析混合型青光眼（mixed glaucoma,MG）住院病人的致病机制.方法 收集 2005年~2009年连续住院患者MG 109只眼（76例）的临床资料,结合眼压、C/D、视野、前房角镜及超声生物显微镜（ultrasound biomicroscopy,UBM）等临床资料,分类分析其混合致病机制的构成.结果 （1）本组病例存在12个致病机制类型：原发性开角型青光眼（primary open-angle glaucoma,POAG、原发性闭角型青光眼（primary angle-closure glaucoma,PACG）、先天性青光眼、新生血管性青光眼、青睫综合征及以下因素：晶状体膨胀或脱位、睫状体囊肿、糖皮质激素、眼外伤或眼内手术、虹膜炎、Fuchs综合征和剥脱综合征继发性青光眼.（2） 本组病例存在7类混合机制致病：POAG合并PACG35只眼,占32.1%;PACG合并继发性闭角型青光眼32只眼（29.4%）;PACG合并继发性开角型青光眼13只眼（11.9%）;POAG合并继发性开角型青光眼11只眼（10.1%）;POAG合并继发性闭角型青光眼10只眼（9.2%）;先天性青光眼合并继发性青光眼5只眼（4.6%）及不同类型的继发性青光眼合并存在3只眼（2.8%）.结论 注意对青光眼发病机制的全面分析,避免明确一种青光眼致病病机制而忽略混合致病机制的存在,以便采取恰当全面的治疗方案;UBM的应用有助于MG致病机制的分析;POAG 合并PACG是MG的主要类型.Objective To analyze the pathogenic mechanism in hospitalized patients with mixed glaucoma. Methods The clinical data of 76 cases （109 eyes） in hospitalized patients with mixed glaucoma from 2005 to 2009 were collected. The compositions of the pathogenic mechanism were analyzed according to intraocular pressure, the ratio of C/D, the results of visual field, gonioscope and ultrasound biomicroscopy （UBM）. Results There were 12 pathogenic mechanisms in the cases including PACG, POAG, congenital glaucoma, neovascular glaucoma, glaucomatocyclitic syndrome, and Fuchs syndrome, iriditis, ocular trauma, swelling crystal body, cysts in the ciliary body, exofoliation syndrome and corticosteroid-induced glaucoma. There were 7 mixed mechanisms in the cases including POAG combined with PACG （35 eyes, 32.1%）; PACG combined with secondary angle-closure glaucoma （32 eyes, 29.4 %）; PACG combined with secondary open-angle glaucoma （13 eyes, 11.9%）; POAG combined with secondary open-angle glaucoma （11 eyes, 10.1 %）; POAG combined with secondary angle-closure glaucoma （10 eyes, 9.2 %）; congenital glaucoma combined with secondary glaucoma （5 eyes, 4.6%） and secondary glaucoma combined with another secondary glaucoma （3 eyes, 2.8%）. Conclusions The multi-analysis of pathogenic mechanisms in patients with glaucoma is very essential in order to choose appropriate treatment. It is helpful for analyzing the pathogenic mechanism of MG with UBM. The main type of MG is POAG combined with PACG.

关 键 词：青光眼 混合型 机制 

分 类 号：R775.2[医药卫生—眼科]