糖皮质激素对原发性肾病综合征患儿眼压及视功能发育的影响  

EFFECTS OF GLUCOCORTICOIDS ON INTRAOCULAR PRESSURE,EYEBALL AND VISUAL FUNCTION DEVELOPMENT IN CHILDREN WITH PRIMARY NEPHROTIC SYNDROME

作　　者：张东兴 李光民[2] 李君[3] 李菁[1] 王双连[1] ZHANG Dongxing;LI Guangmin;LI Jun;LI Jing;WANG Shuanglian(Hebei Tangshan maternal and child health hospital ophthalmology,Tangshan 063000,China)

机构地区：[1]河北省唐山市妇幼保健院眼科,063000 [2]河北省唐山市妇幼保健院影像科 [3]开滦总医院林西医院药学

出　　处：《中国煤炭工业医学杂志》2022年第4期434-439,共6页Chinese Journal of Coal Industry Medicine

基　　金：河北省2018年度医学科学研究重点课题计划(编号:20181363)。

摘　　要：目的 观察原发性肾病综合征患儿全身应用糖皮质激素治疗后眼压的变化及高眼压对其视功能发育的影响。方法 在就诊于唐山市妇幼保健院小儿肾脏科的患者中,按照原发性肾病综合征的诊断标准,选择2015年1月—2017年1月期间,需要全身糖皮质激素治疗的102例首次发病儿童。在全身糖皮质激素治疗后,以眼压值为指标,可将其分为激素性高眼压组和眼压正常组。在治疗前和治疗后各时间点检查眼压、眼轴长度、前房深度、角膜曲率、屈光度,以各项参数建立Excel数据库并进行统计学分析。结果 激素性高眼压组治疗后眼压、眼轴长度、前房深度、屈光度等指标,与治疗前差异均具有统计学意义(P<0.05),且不同时期差异具有统计学意义(P<0.05)。治疗后激素性高眼压组与眼压正常组患儿相比,高眼压组患儿眼轴长度更长,前房深度更大,屈光度更低,角膜曲率趋于平坦更显著。结论 原发性肾病综合征患儿经过全身糖皮质激素治疗后眼压升高,随着眼压的升高,前房深度变深,眼轴延长,角膜曲率有平坦化趋势,且高眼压组较眼压正常组变化更为显著,患儿近视化趋势更加显著。这表明,原发性肾病综合征患儿因全身糖皮质激素治疗引起的高眼压,可能会影响眼球正常的生长发育,对近视的发生以及发展起到促进作用。Objective To observe the changes of intraocular pressure(IOP) in children with primary nephrotic syndrome after systemic glucocorticoid treatment and the effect of high IOP on visual function development.Methods From January 2015 to January 2017, 102 first-onset children who met the diagnostic criteria of primary nephrotic syndrome and needed systemic glucocorticoid treatment were selected. After systemic glucocorticoid treatment, the patients were divided into two groups according to the intraocular pressure(IOP) values: hormone-induced ocular hypertension group and normal intraocular pressure group. The following ophthalmic examinations were performed before hormone application and the first week, the first month, the sixth month and full year after treatment: intraocular pressure, ocular biometrics parameters(ocular axial length, anterior chamber depth, corneal curvature), and diopterother parameters were recorded. All data were analyzed statistically by using Excel to establish a database.Results For indicators such as intraocular pressure, axial length, anterior chamber depth, and refractive power, the differences between different periods after treatment and before treatment were statistically significant(P<0.05), and the differences between different periods were statistically significant(P<0.05). Compared with the normal intraocular pressure group, the high intraocular pressure group had a longer axial length, a larger anterior chamber depth, a lower diopter, and a more significant flattening trend of corneal curvature. Conclusion Systemicapplication of glucocorticoids in children with primary nephrotic syndrome can cause intraocular pressure to increase. With the increase in intraocular pressure, the depth of the eye axis and the anterior chamber are both prolonged, and the corneal curvature has a flattening trend. Moreover, the changes in the high intraocular pressure group were more significant than those in the normal intraocular pressure group, and the tendency of myopia was more significant. It can

关 键 词：肾病综合征 糖皮质激素 高眼压 眼球生物学参数 屈光度 

分 类 号：R72[医药卫生—儿科]