麻风性葡萄膜病的调查研究  

Epidemiological survey on uvea disease in leprosy

作　　者：严良斌[1] 张国成[1] 叶干运[1] 郑志菊[1] 余美文[1] 钱坚革[1] 周群[2] 

机构地区：[1]中国医学科学院中国协和医科大学皮肤病研究所,南京210042 [2]南京大学医学院附属鼓楼医院眼科

出　　处：《中国麻风皮肤病杂志》2003年第2期108-110,共3页China Journal of Leprosy and Skin Diseases

基　　金：中国医学科学院中国协;医科大学青年科学基金资助课题

摘　　要：目的 :　了解麻风性葡萄膜病的特点和患病情况。方法 :　选择江苏泰兴市存活的麻风治愈者及现症患者 10 4 5例 ,由培训的眼科医生检查 ,资料输入计算机统计分析。结果 :　麻风杆菌的直接损害、II型麻风反应和继发性角膜病引起的葡萄膜病占 7.85 % ,现症 (2 5 % )、多菌型 (2 4 .4 7% )和病期长(38.93% )的病人患病率明显增高。损害以肉芽肿虹膜睫状体炎为特征 ,睫状充血占 14 .73% ,瞳孔形状不规则 (4 8.0 6 % )、光反应消失 (4 5 .74 % )、虹膜后粘连 (35 .6 6 % )和小瞳孔 (2 8.6 8% )比较常见 ,其次为瞳孔闭锁 (19.38% )、虹膜前粘连 (17.83% )、虹膜萎缩 (17.0 5 % )、色素脱落 (15 .5 % )和膜闭 (14 .73% )。慢性虹膜睫状体炎并发白内障占 81.5 4 % ,视力减退占 6 0 % ,眼盲为 4 0 .2 4 % ,可治盲为 5 2 .73%。结论 :麻风性葡萄膜病可因麻风杆菌直接侵犯 ,也可由II型麻风反应引起。好发于现症、多菌型及病期长的病人。损害以肉芽肿虹膜睫状体炎为特征 。Objective:To determine the prevalence and characteristics of the uvea disease in leprosy. Method: One thousand and forty-five cured and active cases of leprosy in Taixing, Jiangsu were checked by specially trained ophthalmologists. Results:Uvea disease caused by direct invasion of M. leprae, type-II reaction, and secondary corneal disorders were found in 7.85% of the all investigated cases. The prevalence rate of the disease was found significantly higher in active cases (25%), multi-bacillary cases (24.47%) and those with long duration of the disease (38.93%). It was characterized by granulomatous iridocyclitis, with presenting of redness of the cilary body (14.73%), irregular pupil (48.06%), diminished light reaction (45.74%), irisposterior synechiae (35.66%), small pupil (28.68%), blocked pupil (19.38%), synechia iridis anterior (17.83%), shrivel uvea (17.05%), depigmentation (15.5%), and iridoleptynsis (14.73%). Secondary cataract was found in 81.54% of those with chronic iridocyclitis, of which 60% of reduced vision, 40.24% blindness, and 52.73% curable blindness. Conclusion :The uvea disease in leprosy could be caused either by direct invasion of the M. leprae or type-II reaction. It was commonly found in active cases, multi-bacillary cases and those with long duration of the disease. The clinical characteristic is granulomatous iridocyclitis, and most of them develop cataract and loss of vision.

关 键 词：麻风性葡萄膜病 调查 继发性角膜病 麻风杆菌 麻风反应 

分 类 号：R755[医药卫生—皮肤病学与性病学] R773.9[医药卫生—临床医学]