梅毒性巩膜炎的临床特征与治疗

发布时间：2018-01-16 16:31

本文关键词：梅毒性巩膜炎的临床特征与治疗　出处：《眼科新进展》2017年05期 　论文类型：期刊论文

【摘要】：目的分析总结梅毒性巩膜炎患者的临床特征及治疗结果。方法对我院2011年至2016年确诊的梅毒性巩膜炎患者临床资料进行回顾性研究,对梅毒性巩膜炎的临床特征及预后结果进行评价与分析。结果7例(7眼)患者经临床及血清学检查确诊为梅毒性巩膜炎。所有患者就诊前未知梅毒感染,有3例患者眼部是唯一的临床表现。梅毒血清学检查包括梅毒快速血浆反应素试验及梅毒螺旋体颗粒凝集试验,两者均为阳性。所有患者HIV检测均为阴性,排除HIV感染。7例患者均为单眼发病,病程1周~2 a。患者均以不同程度的眼红、眼痛伴视力下降等为主诉就诊。患者中2例为前部浅层巩膜炎,3例为前部结节性前巩膜炎,1例为弥漫性前巩膜炎,1例为弥漫性表层巩膜炎伴有急性梅毒性后部鳞状脉络膜视网膜病变。所有患者均接受青霉素治疗,治疗后巩膜炎症均完全消退。结论梅毒感染性巩膜炎较少见且易被误诊,主要表现为各种类型的前部巩膜炎。对于可疑病例要进行梅毒血清学检测以明确诊断。正确驱梅治疗后,患者预后较好。
[Abstract]:Objective to analyze the clinical features and treatment results of patients with syphilis sclera. Methods the clinical data of patients with syphilis sclera from 2011 to 2016 were retrospectively studied. The clinical features and prognosis of syphilis sclera were evaluated and analyzed. Results 7 patients with syphilis were diagnosed as syphilis by clinical and serological examination. Syphilis serological examination included rapid plasma reactivity test and Treponema pallidum agglutination test, both of which were positive. HIV was negative in all patients. The patients who excluded HIV infection were all monocular. The course of disease was 1 week and 2 years. The main complaints of the patients were eye redness, eye pain and visual acuity decline, among which 2 cases were anterior superficial sclera inflammation. 3 cases were anterior nodular anterior scleral inflammation, 1 case was diffuse anterior sclera inflammation and 1 case was diffuse superficial sclera with acute squamous chorioretinopathy. All patients were treated with penicillin. Conclusion syphilis infective sclera inflammation is rare and easy to be misdiagnosed. The main manifestations are various types of anterior scleral inflammation. For suspicious cases, syphilis serology should be detected to make a definite diagnosis.
【作者单位】：天津医科大学眼科医院;
【分类号】：R772.3
【正文快照】： 梅毒是由梅毒螺旋体引起的感染性疾病。根据梅毒临床症状可分为一期、二期及潜伏期,严重者可出现三期梅毒表现。眼梅毒可发生于梅毒任何阶段,但多发于二期和潜伏期。眼部受损可以是梅毒的唯一临床表现,也可以是梅毒的首发症状。在眼梅毒中最常见的眼部表现是梅毒性葡萄膜炎,梅

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