早期Vogt-小柳-原田综合征患者视力预后的单因素分析  

Single factor analysis in visual prognosis in patients with vogt-koyanagi-harada syndrome at the early stage

作　　者：郭娅玲[1] 许平[2] 何剑峰[2] 

机构地区：[1]广西医科大学护理学院,530021 [2]广西医科大学第一附属医院

出　　处：《中国医学创新》2010年第22期1-3,共3页Medical Innovation of China

摘　　要：目的探讨对早期Vogt-小柳-原田综合征患者视力预后有明显影响的单因素。方法回顾性分析笔者所在医院2005年10月～2008年6月来笔者所在医院眼科中心就诊的早期VKH患者的临床资料,记录的数据包括年龄、性别、发病到治疗的时间、初视力、治疗后的视力变化过程、就诊时的眼部及眼外表现、治疗、并发症、复发以及随访时间等。结果共有30例患者60眼被纳入研究,其中男13例(43.3%),女17例(57.6%);年龄17～66岁,平均(35.57±12.36)岁;入院时病史为3～30 d,平均为(15.75±7.39)d。60只患眼中,42眼(70.0%)愈后视力大于等于1.0,54眼(90.0%)大于0.5,只有1眼愈后视力低于0.1。10眼出现了并发症。对视力预后的单因素分析结果表明:发病到开始治疗的时间(P=0.012)、虹膜后粘连(P=0.002)、视网膜脱离(P<0.001)、晚霞状眼底(P<0.001)以及并发症(P<0.001)与早期VKH患者的视力预后存在统计学意义的相关性。结论早期VKH患者给予足量及长期的糖皮质激素治疗大多数可获得满意的治疗效果。发病到开始治疗的时间、虹膜后粘连、视网膜脱离、晚霞状眼底以及并发症的发生,是影响此类患者1.0及1.0以上视力预后的重要因素。Objective Identify single prognostic factors for final visual acuity(VA) in patients with VKH syndrome at the early stage.Methods Patients diagnosed with VKH syndrome in one month after onset of disease between October 2005 and June 2008 were reviewed.The data recorded included age,sex,initial and final VA,interval between the onset of disease and starting treatment, the process of visual acuity variations from commencing treatment,clinical ocular findings and extraocular manifestations at presentation,treatment received,complication,recurrence,and follow -up duration.Results Sixty eyes of thirty patients were identified. There were 13(43.3%)male and 17(56.7%)female patients with a mean age of 35.57 years(range 17 -66 years ).The mean duration of disease at presentation was(15.75±7.39)days.Of the 60 eyes,42(70.0%)eyes did finally achieve VA of≥20/20, 54 eyes(90.0%)with a VA of > 20/40,one eye was detected to have a final VA of≤20/200.Ten eyes developed at least one complication.The following factors were significantly associated with final VA of≥20/20 by Univariate analysis;early presentation (P =0.012),absence of posterior synechiae(P =0.002 ),retinal detachment(P <0.001).sunset glow fundus(P <0.001)and complications (P< 0.001 ).Conclusion Intensive and prolonged systemic treatment with corticosteroids is recommended for the initial patients with VKH symdrome in the early stage.The time for presentation,posterior synechiae.retinal detachment,sunset glow fundus and complication were found out to be the influential factors for final VA of≥20/20 in patients with VKH syndrome at the early stage.

关 键 词：VOGT-小柳-原田综合征 视力 预后 晚霞状眼底 

分 类 号：R773.9[医药卫生—眼科]