环孢素A联合糖皮质激素治疗儿童葡萄膜炎的疗效评价  

Evaluation on the effect of cyclosporin A combined with glucocorticosteroid in the treatment of juvenile uveitis

作　　者：赵菲菲[1] 韦侃侃[1] 侯习武[2] 杨白冰[2] 

机构地区：[1]郑州大学第四附属医院药学部,河南省郑州450044 [2]郑州大学第四附属医院眼科,河南省郑州450044

出　　处：《中国基层医药》2016年第4期509-511,共3页Chinese Journal of Primary Medicine and Pharmacy

基　　金：河南省医学科技攻关计划项目（201303095）

摘　　要：目的：评价环孢素 A 联合糖皮质激素治疗儿童葡萄膜炎的疗效和安全性。方法选择儿童葡萄膜炎患者66例（93眼），根据患者病情，给予环孢素 A 2～5 mg·kg^-1 ·d^-1，早晚各1次口服；泼尼松片0．5～1 mg·kg^-1 ·d^-1，晨起顿服。治疗4～6个月后观察患者炎症控制及视力改善情况，并于治疗前后检测患者肝肾功能、血糖、血压、白细胞计数等指标，定期随访记录患者不良反应发生情况。结果治疗4～6个月后，炎症治愈78眼，好转9眼，无效6眼，总有效率93．55％。视力明显提高者50眼，好转者27眼，无变化者16眼，总有效率82．79％。共有56眼达到脱残标准。治疗期间患者出现肝肾功能损害6例、血常规异常3例、血糖降低3例，经对症治疗后各项指标均控制在正常范围，无全身恶化情况发生。结论环孢素 A 联合糖皮质激素治疗儿童葡萄膜炎疗效较好，且无严重全身毒副反应发生。Objective To explore the clinical efficacy and safety of cyclosporin A combined with glucocorti-costeroid in the treatment of juvenile uveitis.Methods 66 juvenile uveitis patients（93 eyes）were selected.Accord-ing to the conditions,the patients were treated by oral administration of cyclosporin A,2-5mg·kg^-1 ·d^-1,twice per day,combined with prednisone,0.5-1mg·kg^-1 ·d^-1,taken in the morning.After 4-6 months treatment,the inflam-mation control and visual acuity improvement were observed,and before and after treatment liver and kidney function, blood glucose,blood pressure,white blood cell counts were checked.Adverse reactions in patients were recorded with regular follow-up.Results After 4-6 months treatment,heal inflammation 78 eyes,accounted for 83.87%;improved 9 eyes,accounted for 9.68%;no respond in 6 eyes,accounted for 6.45%;the total effective rate was 93.55%.Visual acuity was obviously improved in 50 eyes,improved in 27 eyes and no response in 16 eyes;the total effective rate was 82.79%;56 eyes were removed from residual standard.In the stage of therapy,6 patients had liver and kidney dys-function,6 patients had blood abnormalities,and 3 patients had low blood sugar,all were controlled by symptomatic treatment in the normal range,and no systemic progression.Conclusion Cyclosporin A combined with glucocortico-steroid applied in juvenile uveitis improved the results with obvious clinical effect and fewer systemic side effect.

关 键 词：葡萄膜炎 环孢素A 糖皮质激素 儿童 

分 类 号：R773.9[医药卫生—眼科]