未经抗巨细胞病毒治疗时艾滋病合并巨细胞病毒性视网膜炎的临床特征及其预后  

Clinical characteristics and prognosis of cytomegalovirus retinitis with acquired immune deficiency syndrome without anticytomegalovirus therapy

作　　者：孙挥宇[1] 毛菲菲[1] 李丹[1] 王胜男[1] 柳月红[1] 许雪静[1] 刘彬彬[1] 董愉[1] 

机构地区：[1]首都医科大学附属北京地坛医院眼科,100015

出　　处：《眼科》2016年第3期195-198,共4页Ophthalmology in China

基　　金：首都医科大学基础临床合作基金(14JL91)

摘　　要：目的了解未经抗巨细胞病毒治疗时获得性免疫缺陷综合征（艾滋病）合并巨细胞病毒性视网膜炎的临床特征及其预后。设计回顾性病例系列。研究对象11例未经抗巨细胞病毒治疗的艾滋病合并巨细胞病毒性视网膜炎患者。方法所有患者查矫正视力、非接触眼压、裂隙灯显微镜检查、动态视野、散瞳间接检眼镜检查、眼底照相,并行CD4 T淋巴细胞检测。随访2个月~5年（平均26.2±23.8个月）,观察病程过程中各项指标的变化。主要指标矫正视力、眼前后节情况。结果 11例（21眼）发病,其中14眼无光感,矫正视力〈0.05者2例（2眼）,0.05≤矫正视力〈0.3者1例（1眼）,矫正视力≥0.3者3例（4眼）;21眼中,5眼仅有不同程度的角膜后色素性KP,余16眼除角膜KP外,均有不同程度的白内障;21眼中13眼有不同程度虹膜前后粘连,2例（3眼）合并角膜白斑、角膜血管翳,影响外观。眼底能窥入者9眼,表现为不同程度眼底瘢痕性改变,合并视网膜脱离者2眼。结论未经抗巨细胞病毒治疗的艾滋病合并巨细胞病毒性视网膜炎患者视力预后差,除眼底病变外,还可引起眼前节病变。Objective To analyze the clinical characteristics and prognosis of cytomegalovirus retinitis with acquired immune deficiency syndrome without anticytomegalovirus therapy. Design Retrospective cases series. Particpants 11 patients with cytomegalovirus retinitis combined with acquired immune deficiency syndrome who had not been anticytomegalovirus. Methods Visual acuity, intraocular pressure, slit lamp, visual field and fundus examination were evaluated and observed during the follow-up for 2 months to 5 years（26.2 ±23.8 months）. Main Outcome Measures Vision, anterior segment, fundus. Results In the 21 eyes of 11 patients with cy-tomegalovirus retinitis, 14 eyes were no light perception, two eyes had vision of less than 0.05, one eye had vision of no less than0.05 and less than 0.3,only 4 eyes of them had vision no less than 0.3. Five eyes of 21 eyes had pigmented KP only, 16 of 21 eyes had cataracts, 13 of 21 eyes had anterior and posterior synechia, 3 eyes of 2 patients had keratopathy. 9 eyes which can be seen fundus had fundus scars, 2 of them had retina detachment. Conclusion Patients who have cytomegalovirus retinitis with acquired immune deficiency syndrome without anticytomegalovirus therapy will have poor visual prognosis, can cause the anterior segment lesions, in addition to the fundus lesions.

关 键 词：艾滋病 巨细胞病毒性视网膜炎 抗病毒治疗 预后 

分 类 号：R512.91[医药卫生—内科学] R774.11[医药卫生—临床医学]