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作 者:张钰(综述) 曲毅(审校)[1] ZHANG Yu(Overview);QU Yi(Guidance)(Department of Geriatrics,Qilu Hospital of Shandong University,Jinan 250012,Shandong,China)
机构地区:[1]山东大学齐鲁医院老年医学科,山东济南250012
出 处:《山东大学耳鼻喉眼学报》2022年第5期70-76,87,共8页Journal of Otolaryngology and Ophthalmology of Shandong University
摘 要:眼弓形体病是由刚地弓形虫感染引起的以单侧坏死性视网膜脉络膜炎为典型特征的疾病。当感染弓形虫后,速殖子穿过血-视网膜屏障能感染大部分有核细胞并直接对组织造成破坏,同时也会引起一系列过度的细胞免疫反应,进一步加重组织损害,引发视觉障碍。最终,速殖子能够在自身增殖与宿主免疫抵抗之间建立平衡,以组织包囊的形式长期寄生在宿主体内。临床治疗方面,除传统的乙胺嘧啶和磺胺嘧啶药物治疗外,为实现精准治疗,减少全身用药不良反应,新的联合治疗方案以及抗弓形虫药物也已开始研究并应用。结合目前临床面临的困境,着重对疾病的发病机制和临床治疗进行综述,期望对该病的诊疗提供理论基础。Ocular toxoplasmosis is a unilateral necrotizing retinochoroiditis caused by intraocular infection with Toxoplasma gondii.When people are infected with T.gondii,tachyzoites can cross the blood-retinal barrier and infect most nucleated cells to directly cause tissue damage.At the same time,they can also cause a series of excessive cellular immune responses to further aggravate tissue damage and cause visual impairment.Finally,tachyzoites can create an equilibrium between parasite invasion and host resistance,thus forming tissue cysts in the host.Aside from the traditional drug treatment of pyrimethamine and sulfadiazine in clinical practice,new combined treatment programs and anti-T.gondii compounds have also been studied and applied to achieve precise treatment and reduce the toxic and side effects of systemic drugs.This article focuses on reviewing the pathogenesis and control of ocular toxoplasmosis,together with the current clinical predicaments,so as to provide a theoretical basis for the diagnosis and treatment of this disease in the future.
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