乙胺丁醇中毒性视神经病变对视神经纤维层厚度的影响分析  

Effect of Ethambutol-Induced Optic Neuropathy on the Thickness of Optic Nerve Fiber Layer

作　　者：张彦坤[1] 关艳 李晓霞[2] 翟静洁 李玉静[3] ZHANG Yan-kun;GUAN Yan;LI Xiao-xia;ZHAI Jing-jie;LI Yu-jing(Department of Ophthalmology,Hebei Chest Hospital,Shijiazhuang 050041,China;Department of Pathology,Hebei Chest Hospital,Shijiazhuang 050041,China;Clinical Laboratory of Hebei Chest Hospital,Shijiazhuang 050041,China)

机构地区：[1]河北省胸科医院眼科,河北石家庄050041 [2]河北省胸科医院病理科,河北石家庄050041 [3]河北省胸科医院检验科,河北石家庄050041

出　　处：《药物生物技术》2022年第1期54-57,共4页Pharmaceutical Biotechnology

基　　金：河北省2019年度医学科学研究课题计划项目(No.20191029)。

摘　　要：分析乙胺丁醇中毒性视神经病变对视神经纤维层(RNFL)厚度的影响,回顾性选择本院45例接受乙胺丁醇抗结核治疗患者作为观察组,按照患者治疗6个月时是否发生视野模糊和视力下降分为6例发生组与39例未发生组;同期纳入健康体检者45例作为对照组。用光学相干断层扫描技术(OCT)检查仪测量对照组和观察组患者乙胺丁醇治疗前、治疗后2个月、治疗后6个月及发生组停药2个月时的RNEL厚度。对照组和观察组治疗前、治疗后2个月的各象限RNFL厚度差异无统计学意义(P>0.05);观察组治疗后6个月,视盘颞侧、上方、下方、平均RNFL厚度均大于治疗前、治疗后2个月及对照组(P<0.05)。观察组患者发生及未发生视野模糊和视力下降者的视盘颞侧、上方、下方、平均RNFL厚度均大于对照组(P<0.05);且发生组视盘颞侧、上方、下方、平均RNFL厚度大于未发生组(P<0.05)。发生视野模糊和视力下降者停药2个月时视盘颞侧、上方、下方、平均RNFL厚度分别为(83.29±7.73)μm,(140.33±14.62)μm,(145.29±14.73)μm,(111.42±13.48)μm,与治疗后6个月的RNFL厚度比较(96.99±12.64)μm,(162.03±17.18)μm,(171.15±17.94)μm,(130.15±16.13)μm,差异有统计学意义(P<0.05)。乙胺丁醇中毒性视神经病变患者RNFL有所变厚,且以颞侧象限最明显,临床应加强对乙胺丁醇服药者的随访。To analyze the effect of ethambutol-induced optic neuropathy on the thickness of optic nerve fiber layer(RNFL),45 patients who received ethambutol anti-tuberculosis treatment in the authors hospital were selected retrospectively as the observation group,and were divided into 6 cases and 39 cases according to whether the patients had blurred vision and decreased vision after 6 months of treatment.In the same period,45 healthy people were included as control group.The RNEL thickness of patients in control group and observation group before ethambutol treatment,2 months after treatment,6 months after treatment and 2 months of drug withdrawal was measured by optical coherence tomography(OCT).There was no significant difference in RNFL thickness between control group and observation group before and 2 months after treatment(P>0.05).Six months after treatment,the average RNFL thickness of temporal side,upper part,lower part of optic disc in observation group was larger than that before treatment,two months after treatment and control group(P<0.05).The temporal,upper,lower and average RNFL thickness of the optic disc in patients with and without blurred vision and decreased vision in the observation group were higher than those in the control group(P<0.05).Furthermore,the temporal,upper,lower and average RNFL thickness of optic disc in the occurrence group was larger than that in the non-occurrence group(P<0.05).The mean RNFL thickness of temporal side,upper side,lower side of optic disc(83.29±7.73)μm,(140.33±14.62)μm,(145.29±14.73)μm,(111.42±13.48)μm after 2 months of drug withdrawal,compared with the RNFL thickness after 6 months of treatment(96.99±12.64)μm,(162.03±17.18)μm,(171.15±17.94)μm,(130.15±16.13)μm,the difference was statistically(P<0.05).The RNFL of patients with optic neuropathy induced by ethambutol becomes thicker,especially in temporal quadrant.The follow-up of patients taking ethambutol should be strengthened in clinic.

关 键 词：乙胺丁醇中毒性神经病变 视神经纤维层厚度 光学相干断层扫描技术 

分 类 号：R77[医药卫生—眼科]