不同分期Vogt-小柳-原田患者复发率和并发症情况的回顾分析  

Retrospective analysis of recurrence rate and complications in patients with different stages Vogt-Koyanagi-Harada

作　　者：高延娥[1,2] 刘婷婷[3,2] 王兴荣[3,2] 田庆梅[3,2] 毕宏生[3,2] GAO Yane LIU Tinging WA NG Xingrong et al(Eye Hospital Affiliated to Shandong University of TCM, Jinan 250002, Chin)

机构地区：[1]山东中医药大学眼科研究所,济南250002 [2]山东中医药大学附属眼科医院 [3]山东中医药大学第二附属医院

出　　处：《中国中医眼科杂志》2016年第5期320-323,共4页China Journal of Chinese Ophthalmology

基　　金：国家自然科学基金资助项目(81373826、81503620)

摘　　要：目的观察后葡萄膜炎期和前葡萄膜炎反复发作期VKH患者的疗效以及复发率和并发症情况。方法回顾就诊时患者为后葡萄膜炎期(<2周)45例90眼和前葡萄膜炎反复发作期(2个月至数年)15例30眼的临床资料。对患者行糖皮质激素及中药辨证论治,中西医结合治疗,并进行了平均22个月的随访观察,包括视力、复发率及并发症情况。结果后葡萄膜炎期与前葡萄膜炎反复发作期相比,提高视力明显,差异有统计学意义(P<0.05),复发率也明显降低,差异有统计学意义(P<0.01)。常见的并发症为并发性白内障、青光眼。而脉络膜新生血管(Choroidal neovascularization,CNV)和视神经萎缩仅见于前葡萄膜炎反复发作期患者。结论后葡萄膜炎期是治疗VKH重要的时间窗口。此时期积极治疗,视力预后和复发率以及并发症的发生都明显优于前葡萄膜炎反复发作期。OBJECTIVE To observe the curative effect, the recurrence rate and complications of the patients with Vogt-Koyanagi-Harada（VKH） in posterior uveitis stages and anterior uveitis repeated episodes stages.METHODS The study reviewed clinical data of 45 cases（90 eyes） with Harada disease in posterior uveitis stages（less than 2 weeks） and 15 cases（30 eyes） in anterior uveitis stages（2 months to several years）. The patients were administrated with glucocorticoid and TCM treatment according to syndrome differentiation. The patients were observed about 22 months on average. The corrected visual acuity, recurrence rate and complications were recorded. RESULTS Compared with anterior uveitis repeated episode stages, the eye sights of posterior uveitis stages were improved obviously, the difference was statistically significant（P〈0.05）. Also, the recurrence rates were significantly reduced, the difference was statistically significant（P〈0.01）. The common complications were concurrent cataract and glaucoma. The choroid neovascularization（Choroidal neovascularization, CNV）and optic atrophy only onset in patients with anterior uveitis repeated episodes. CONCLUSIONS The posterior uveitis stages was an important period to treat the VKH. Active treatment in this session led to significantly better outcome in visual acuity, recurrence rate and the incidence of complications than recurrent stage of the anterior uveitis stages.

关 键 词：VOGT-小柳-原田综合征 葡萄膜炎 中西医结合 

分 类 号：R773.9[医药卫生—眼科]