50岁以下的非动脉炎性前部缺血性视神经病变患者的临床特点

发布时间：2018-02-09 10:08

本文关键词： 非动脉炎性炎性前部缺血性视神经病变临床特点　出处：《中国中医眼科杂志》2016年01期 　论文类型：期刊论文

【摘要】：目的探讨50岁以下非动脉炎性前部缺血性视神经病变(NAION)患者的临床特点及发病危险因素。方法回顾性病例研究。选取2012年1月至2015年1月在解放军总医院确诊为NAION的患者93例,按年龄分为两组,A组为50岁以下的患者共37例(52只眼),B组为50岁以上的患者共56例(66只眼),对两组患者的一般情况、病因、系统性疾病史、发病情况以及与神经眼科有关的各项检查结果进行比较分析。结果 A组发病时出现遮挡感症状的患者相对较少(A组22/37,59.5%;B组45/56,80.4%,P=0.035),但对侧健眼更易受累(A组15/37,40.5%;B组10/56,17.9%,P=0.019)。初始视力两组接近,最终视力A组在≤20/200、20/100~20/50、≥20/40的眼数比例依次增高,分别为5.8%(3/52)、28.8%(15/52)、65.4%(34/52),B组的相应比例为22.7%(15/66)、47.0%(31/66)、30.3%(20/66),前者好于后者(P0.001)。两组在高血压、糖尿病、高脂血症患病比例,视野、荧光素眼底血管造影(FFA)表现,视盘周围视网膜神经纤维层(RNFL)厚度变化以及颈动脉超声、24 h动态血压监测结果等方面,均无明显差异(P0.05)。结论 50岁以下NAION患者与50岁以上NAION患者不完全相同,50岁以下患者发病时的遮挡感症状相对少见,视力预后好于50岁以上NAION患者,但对侧眼更易受累。对此类患者应提高认识,密切随访,以减少对侧眼的发病机会。
[Abstract]:Objective to explore under the age of 50 in nonarteritic anterior ischemic optic neuropathy (NAION) clinical characteristics and risk factors of patients. Methods: retrospective study. From January 2012 to January 2015 in PLA general hospital diagnosed 93 cases of NAION patients were divided into two groups, A group of patients under the age of 50 in total 37 cases (52 eyes), group B for more than 50 years old with a total of 56 cases (66 eyes), causes the general situation of the two groups of patients, systemic disease history, the incidence and the inspection related to neuro ophthalmology were compared. The patients with relatively few symptoms occlusion results A group when the disease (A group 22/37,59.5% B group; 45/56,80.4%, P=0.035), but the contralateral eyes more involved (A 15/37,40.5% group; B group 10/56,17.9%, P=0.019). The initial visual acuity of two were similar to that of the final visual acuity in group A were less than 20/200,20/100~20/50, the number of eyes ratio was above 20/40 in order to increase High, respectively 5.8% (3/52), 28.8% (15/52), 65.4% (34/52), the corresponding proportion of group B was 22.7% (15/66), 47% (31/66), 30.3% (20/66), the former is better than the latter (P0.001). The two groups in hypertension, diabetes, hyperlipidemia prevalence ratio, vision, fluorescence in fundus angiography (FFA), peripapillary retinal nerve fiber layer (RNFL) thickness and carotid artery ultrasound, 24 h ambulatory blood pressure monitoring results, showed no significant difference (P0.05). Conclusion the NAION patients aged 50 years and over 50 years old with NAION were not exactly the same, the patients below 50 years of age at onset occlusion symptoms are relatively rare, eyesight good prognosis in the NAION patients over the age of 50, but the contralateral eye more involved. Such patients should be closely followed up, raise awareness, to reduce the incidence of the contralateral eye.

【作者单位】：中国人民解放军总医院眼科;首都医科大学友谊医院;北京市隆福医院;北京市东直门医院;
【基金】：视神经炎诊断、视神经功能评价设备的开发(2015AA020511)
【分类号】：R774.6

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