环境因素对Leber遗传性视神经病变发病和视力预后的影响  

Influence of environmental factors on the onset and prognosis of Leber hereditary optic neuropathy

作　　者：徐日 徐歆桐 刘泽[1] 徐全刚[1] 张磊[1] XU Ri;XU Xintong;LIU Ze;XU Quangang;ZHANG Lei(Department of Neuro-ophthalmology,the Third Medical Center,PLA General Hospital,Beijing 100039,China)

机构地区：[1]解放军总医院第三医学中心神经眼科,北京100039

出　　处：《中国眼耳鼻喉科杂志》2024年第6期461-464,共4页Chinese Journal of Ophthalmology and Otorhinolaryngology

摘　　要：目的分析环境因素在Leber遗传性视神经病变(LHON)发生和发展中的作用。方法回顾性纳入2021年4月11日—2023年4月11日于解放军总医院第三医学中心神经眼科病区就诊的LHON患者,收集患者一般临床资料、可能诱发疾病和影响患者视力预后的相关环境因素。根据末次随访时的最佳矫正视力(BCVA),将患者分为低视力组和非低视力组,比较2组患者的一般临床特征、发病诱因并采用logistic回归模型分析影响患者视力预后的相关环境因素。结果研究共纳入76例患者,平均年龄为(22.07±11.25)岁,其中男性66例(86.8%)、女性10例(13.2%),男:女=6.6:1;55例(71.2%)患者无明显诱因出现视力下降,10例(13.2%)因熬夜、6例(7.9%)因心理上存在较大学业压力、5例(6.6%)因过度用眼后发病。多因素分析结果显示,过度用眼(OR=0.06,P=0.04)是影响LHON患者视力预后的危险因素。结论环境因素可能通过影响线粒体功能而导致LHON发生以及影响患者的视力预后。熬夜、过度用眼和心理上存在较大学业压力是诱发LHON发病的相关因素;另外,过度用眼是LHON患者视力预后较差的危险因素。Objective To observe and analyze the role of environmental factors in the occurrence and development of Leber hereditary optic neuropathy(LHON).Methods Retrospective inclusion.From April 11,2021 to April 11,2023,general clinical data and related environmental factors that may induce LHON and affect the visual prognosis of patients were collected in the Neuro-ophthalmology Section of the Third Medical Center of the PLA General Hospital.According to the best corrected visual acuity(BCVA)at the last follow-up,patients were divided into low visual acuity group and non-low visual acuity group.The general clinical characteristics and pathogenesis of the two groups were compared,and the related environmental factors affecting the visual acuity prognosis were analyzed by logistic regression model.Results A total of 76 patients with an average age of(22.07±11.25)years were included in the study,including 66 males(86.8%)and 10 females(13.2%).The male-to-female ratio was 6.6:1;Fifty-five patients(71.2%)had visual impairment without obvious causes,10 patients(13.2%)were due to staying up late,6 patients(7.9%)were due to psychological academic pressure,and 5 patients(6.6%)were due to excessive eye use.Multivariate analysis showed that excessive eye use(OR=0.06,P=0.04)was a risk factor for poor visual prognosis in LHON patients.Conclusions Environmental factors may contribute to the development of LHON by affecting mitochondrial function and the visual prognosis of patients.Staying up late,excessive eye use and academic pressure were the related factors that induced LHON.In addition,excessive eye use is a risk factor for poor visual outcomes in LHON patients.

关 键 词：LEBER遗传性视神经病变 环境因素 预后 影响因素分析 

分 类 号：R774[医药卫生—眼科]