感染性葡萄膜炎的诊治观察  

Clinical observation of diagnosis and treatments for infectious uveitis

作　　者：成拾明[1] 张勇[1] 李欣[2] 齐佳[1] 袁均[1] 何国磊 Cheng Shiming;Zhang Yong;Qi Jia;Juan Jun;He Guolei;Li Xin(Department of Ophthalmology, Taihe Hospital, Hubei University of Medicine, 8hiyan, Hubei 442000;Hubei University of Medicine and Pharmacy, 8hiyan, Hubei 442000, China)

机构地区：[1]湖北医药学院附属太和医院眼科,湖北十堰442000 [2]湖北医药学院

出　　处：《临床眼科杂志》2018年第2期140-144,共5页Journal of Clinical Ophthalmology

基　　金：2017年院级基金:2017JJXM064;2017年省卫生和计划生育委员会基金:WJ2017F078

摘　　要：目的探讨感染性葡萄膜炎的临床特点及诊治疗效。方法回顾分析2011年8月至2016年9月在十堰市太和医院眼科诊断为感染性葡萄膜炎并接受住院治疗患者的病例资料。结果 18例(19只眼)感染性葡萄膜炎患者,其中急性视网膜坏死综合征8例、弓形虫性葡萄膜炎3例、弓蛔虫性葡萄膜炎1例、弓蛔虫合并弓形虫性葡萄膜炎1例及结核性葡萄膜炎5例。8例急性视网膜坏死综合征分别经过药物治疗或药物联合手术治疗,仅2例患者视力有轻度提高,余病情稳定,但视力无改善。1例弓形虫性葡萄膜炎因延误治疗导致视力降为光感/眼前,另外2例弓形虫性葡萄膜炎患者经过治疗后视力均得到了提高。1例弓蛔虫性葡萄膜炎经过药物治疗后行玻璃体手术,视力由0.5提高到0.6;1例弓蛔虫合并弓形虫性葡萄膜炎经过对症治疗后视力由0.1提高到0.15。结核性葡萄膜炎患者经过抗结核等对症治疗后病情稳定,视力均有不同程度的提高。结论弓形虫、弓蛔虫及结核性葡萄膜炎通常经过正确及时的治疗后,病情稳定,视力有改善。急性视网膜坏死综合征患者通常病情较重,预后相对较差。Objective To investigate the clinical characteristics and treatment efficacy for infectious uveitis.Methods To retrospectively analyze case information of patients with infectious uveitis who were hospitalized in Taihe Hospital between Aug 2011 and Sep 2016. Results There were 18 cases in the study,including 8 acute retinal necrosis（ARN）,1 ocular toxocariasis,3 ocular toxoplasmosis,1 ocular toxoplasmosis combined with ocular toxocariasis,and 5 ocular tuberculosis cases. Only in 2 ARN cases visual acuity slightly improved after medication and/or surgery. 2 ocular toxoplasmosis patients obtained improved visual acuity after treatment,and the other 1 patient deteriorated to light perception due to delayed treatment. Visual acuity improved in 1 ocular toxocariasis patient from 0. 5 to 0. 6. A patient with ocular toxoplasmosis that complicated with ocular toxocariasis slight improved in visual acuity（ from 0. 1 to 0. 15）. Visual acuity improved to different degrees when ocular tuberculosis was treated. Conclusions Ocular toxoplasmosis,ocular toxocariasis and ocular tuberculosis could be treated to achieve stable ocular condition and improved visual acuity. ARN progresses rapidly with serious condition and has poor prognosis.

关 键 词：感染性葡萄膜炎 弓蛔虫葡萄膜炎 弓形虫葡萄膜炎 结核性葡萄膜炎 急性视网膜坏死综合征 

分 类 号：R773[医药卫生—眼科]