儿童与成人眼弓蛔虫病临床特征差异与预后分析  

Differences in clinical characteristics and prognosis analysis between children and adults with ocular toxocariasis disease

作　　者：林诗群 肖星宇 周艳 张美芬 陈有信 戴荣平 Lin Shiqun;Xiao Xingyu;Zhou Yan;Zhang Meifen;Chen Youxin;Dai Rongping(Department of Ophthalmology,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences&Peking Union Medical College,Beijing 100730,China)

机构地区：[1]中国医学科学院北京协和医院眼科,中国医学科学院北京协和医学院,北京100730

出　　处：《中国医师杂志》2024年第5期646-650,共5页Journal of Chinese Physician

基　　金：国家自然科学基金(82271112)。

摘　　要：目的研究儿童与成人眼弓蛔虫病(OT)临床特征的差异,分析其预后。方法本研究为回顾性队列研究,纳入2017年9月至2023年9月北京协和医院眼科收治的37例(37只眼)OT患者,其中成人患者12例(12只眼),儿童患者25例(25只眼)。比较儿童与成人患者的临床特征差异及预后。结果儿童组中16%(4/25)的患眼伴有高眼压,成人组无患眼伴有高眼压。所有患眼均出现玻璃体炎症,两组玻璃体炎症等级比较差异有统计学意义(P<0.05)。成人组OT类型以不典型表现型OT为主,与儿童组差异有统计学意义(P<0.05)。成人组出现视网膜血管炎、黄斑水肿、视网膜表面增殖膜的比例高于儿童组(均P<0.05)。经口服阿苯达唑、皮质类固醇治疗后,两组黄斑中心凹厚度、眼前节炎症均显著改善(均P<0.05)。儿童组眼局部使用类固醇药物的比例高于成人组(P<0.05)。结论成人OT与儿童OT相比大多无特征性体征,成人OT以不典型表现型OT为主。成人OT的预后较好,且不容易发生炎症反复。在大多数情况下,抗寄生虫和抗炎治疗是安全有效的。Objective To study the differences in clinical characteristics between children and adults with ocular roundworm disease(OT)and analyze its prognosis.Methods This study was a retrospective cohort study,which included 37 patients(37 eyes)with ocular toxocariasis disease admitted to the Department of Ophthalmology,Peking Union Medical College Hospital from September 2017 to September 2023,including 12 adult patients(12 eyes)and 25 pediatric patients(25 eyes).We compared the clinical differences and prognosis between pediatric and adult patients.Results 16%(4/25)of the affected eyes in the child group had high intraocular pressure,while the adult group had no affected eyes with high intraocular pressure.All affected eyes showed vitreous inflammation,and there was a statistically significant difference in the level of vitreous inflammation between the two groups(P<0.05).The majority of OT types in the adult group were atypical phenotype OT,with a statistically significant difference compared to the child group(P<0.05).The proportion of retinal vasculitis,macular edema,and proliferative membrane on the retinal surface in the adult group was higher than that in the child group(all P<0.05).After oral treatment with albendazole and corticosteroids,the thickness of the macular fovea and anterior segment inflammation in both groups were significantly improved(all P<0.05).The proportion of local use of steroid drugs in the children′s group was higher than that in the adult group(P<0.05).Conclusions Compared with pediatric OT,adult OT mostly has no characteristic signs,and adult OT is mainly characterized by atypical phenotype OT.Adult OT has a better prognosis and is less prone to recurrent inflammation.In most cases,antiparasitic and anti-inflammatory treatments are safe and effective.

关 键 词：眼弓蛔虫病 光学相干断层扫描 预后 

分 类 号：R532.11[医药卫生—内科学]