色素膜炎的病因及临床特征分析

发布时间：2018-05-07 18:59

本文选题：色素膜炎 + 病因　；参考：《吉林大学》2017年硕士论文

【摘要】：目的:分析探讨色素膜炎的发病类型、性别、年龄、病因、视力、复发及并发症分布特征。方法:收集自2015年9月至2016年12月就诊我院的色素膜炎144例184眼资料,记录性别、年龄、视力、临床诊断、复发及并发症等临床资料,采用统计学方法进行分析。结果:(1)疾病类型分布:按发病部位分前、中间、后、全色素膜炎,分别占59.72%、2.78%、8.33%、29.17%。根据病程分急性、慢性及复发性,分别为60.42%、39.58%、45.83%。(2)性别分布:患者男女比为1.76:1。前色素膜炎中男女比为1.39:1,中间、后色素膜炎均为男性,全色素膜炎男女比为1.33:1。(3)年龄分布:发病年龄在17-83岁,平均为(43.44±15.55)岁。其中前、中间、后、全色素膜炎分别为(41.49±15.98)岁、(38±3.46)岁、(36.5±16.51)岁、(49.95±13.09)岁。发病年龄小于20岁者6.94%,20-60岁年龄段者77.78%,60岁以上者(包括60岁)15.28%。(4)病因分布:患者病因明确者50%。前色素膜炎以特发性(29.17%)、血清阴性椎关节病变伴发(11.11%)、青光眼睫状体炎综合征(6.94%)为主,中间色素膜炎均为特发性,后色素膜炎以特发性(5.56%)为主,全色素膜炎患者以特发性(12.5%)、VKH综合征(9.72%)为主。(5)视力分布:36.96%的患眼初诊BCVA0.5,27.17%为视力损害,20.65%处于低视力水平,15.22%为盲水平。经药物治疗,预后视力,65.21%的患眼BCVA0.5,11.96%为视力损害,14.13%处于低视力水平,盲水平8.7%。前色素膜炎预后BCVA0.5眼占78%,视力损害眼8%,低视力水平眼8%,盲水平眼6%;中间色素膜炎预后BCVA均在视力损害范围;后色素膜炎预后BCVA0.5眼占55.56%,视力损害眼33.33%,低视力水平眼11.11%;全色素膜炎预后BCVA0.5眼占51.61%,视力损害眼9.68%,低视力水平眼22.58%,盲水平眼16.13%。双变量相关性分析预后BCVA与初诊BCVA呈正相关。(6)复发:平均复发时间为43.2个月,男女复发比为2.67:1,复发平均年龄为(46.64±14.60)岁。前、后、全色素膜炎复发率分别为39.53%、83.33%、53.38%,中间色素膜炎未见复发。复发患眼初诊BCVA0.5者13.04%,视力损害眼18.48%,低视力水平眼8.70%,盲水平眼8.70%。经治疗后终末视力,BCVA0.5者25%,视力损害眼7.61%,低视力水平眼9.78%,盲水平眼5.43%。复发与预后BCVA呈负相关性。(7)并发症:眼部并发症患者男女性别比为2:1。50%患者出现眼部并发症,以ME(33.33%)、并发性白内障(25%)、虹膜后粘连(25%)、继发性青光眼(19.44%)为主。前色素膜炎以并发性白内障(18.60%)、继发性青光眼(11.63%)、虹膜后粘连(9.30%)为主,后色素膜炎以ME(66.66%)为主,全色素膜炎以ME(33.33%)、虹膜后粘连(19.05%)、黄斑前膜(14.29%)为主。伴有眼部并发症患者初诊时,23.91%的患眼BCVA0.5,32.61%为视力损害,19.57%处于低视力水平,盲水平23.91%。经治疗后预后视力,45.64%的患眼BCVA0.5,19.57%为视力损害,19.57%处于低视力水平,盲水平23.91%。眼部并发症与初诊BCVA及预后BCVA呈负相关,眼部并发症与复发呈正相关。结论:(1)眼色素膜炎以中青年男性为主,不同年龄段、不同类型性别分布不同。(2)本研究中发病类型以前色素膜炎最常见,全色素膜炎次之,后部、中间色素膜炎少见。病因明确者为以血清阴性椎关节病变伴发的前色素膜炎、VKH综合征、青光眼睫状体炎综合征为主。前色素膜炎中以特发性、血清阴性椎关节病变伴发常见,全色素膜炎以特发性、VKH综合征为主,其他类型均以特发性为主。(3)本研究中患眼视力不同程度受损,且具有一定致盲性。前色素膜炎经治疗后视力预后良好,但依然存在致盲风险;中间、后色素膜炎患者视力恢复有限;全色素膜炎易致盲。(4)本研究中复发以中年男性多见,前色素膜炎复发率最高,其次为全色素膜炎。复发影响视力预后,对各类型色素膜炎视力均具有一定损伤。(5)本研究中眼部并发症男性多于女性,主要为虹膜后粘连、并发性白内障、继发性青光眼及ME。不同类型并发症因型而异。并发症影响初诊及预后BCVA视力。疾病的复发影响并发症的发生。
[Abstract]:Objective: to analyze the incidence of pigmented meningitis, sex, age, etiology, visual acuity, recurrence and complications. Methods: 184 eyes of 144 cases of pigmented meningitis in our hospital from September 2015 to December 2016 were collected, and the clinical data of sex, age, vision, clinical diagnosis, recurrence and complications were recorded, and statistical methods were used. Analysis. Results: (1) distribution of disease types: according to the position of the disease before, middle, after, total pigmented meningitis, accounted for 59.72%, 2.78%, 8.33%, 29.17%. according to the course of acute, chronic and recurrent, respectively 60.42%, 39.58%, 45.83%. (2) sex distribution: the ratio of men and women to 1.76:1. pre pigmented meningitis is 1.39:1, middle, and post pigmented meningitis is male Sex, total pigmented meningitis is 1.33:1. (3) age distribution: the age of onset is 17-83 years, and the average age is (43.44 + 15.55) years. Among them, the former, middle, and later, (41.49 + 15.98) years, (38 + 3.46) years, (36.5 + 16.51) years, (49.95 + 13.09) years old. The distribution of 15.28%. (4) etiology: the patients with clear etiology, 50%. pre pigmented meningitis (29.17%), seronegative vertebral joint lesions (11.11%), glaucoma ciliary body syndrome (6.94%), middle pigmented meningitis are idiopathic, post pigmented meningitis is idiopathic (5.56%), and all pigmented meningitis patients with idiopathic (12.5%), VKH synthesis Sign (9.72%) mainly. (5) visual acuity distribution: 36.96% of the first diagnosed BCVA0.5,27.17% were visual impairment, 20.65% were low vision and 15.22% were blind. After drug treatment, the prognosis of the eyes, 65.21% of the eyes were impaired in visual acuity, 14.13% were in low vision, and the prognosis of BCVA0.5 eyes was 78% and visual impairment after the blind level of 8.7%. premeningitis. Eye 8%, low vision horizontal eye 8%, blind horizontal eye 6%, intermediate pigmented meningitis in the range of BCVA in visual impairment, posterior pigmented meningitis in BCVA0.5 eyes, 55.56%, visual impairment 33.33%, and low vision, 11.11%, 51.61% in BCVA0.5 eyes, 9.68% in visual impairment, 22.58% in low vision level, and 16.13%. bivariate blind in horizontal eyes. There was a positive correlation between the prognosis BCVA and the first diagnosis of BCVA. (6) recurrence: the average recurrence time was 43.2 months, the recurrence ratio of men and women was 2.67:1, the average age of relapse was (46.64 + 14.60) years. The recurrence rate of the total pigmented meningitis was 39.53%, 83.33%, 53.38%, and the intermediate pigmented meningitis was not recurred. The recurrence rate was 13.04% and the visual impairment. Eye 18.48%, low vision level 8.70%, blind horizontal eye 8.70%. after treatment of final visual acuity, BCVA0.5 25%, visual impairment 7.61%, low vision 9.78%, blind level of 5.43%. recurrence and the prognosis BCVA negative correlation. (7) complications: eye complications of men and women and sex ratio of patients with 2:1.50% eye complications, ME (33.33%), concurrence Cataract (25%), posterior synechia (25%), secondary glaucoma (19.44%). Anterior pigmented membrane inflammation (18.60%), secondary glaucoma (11.63%), posterior synechia (9.30%), ME (66.66%), full pigmented meningitis with ME (33.33%), posterior synechia (19.05%), and macular membrane (14.29%). At the initial diagnosis of complications, 23.91% of the patients had visual impairment BCVA0.5,32.61% and 19.57% in low vision. Blind level of 23.91%. was treated with visual acuity after treatment. 45.64% of the patients had visual impairment with BCVA0.5,19.57%, 19.57% were in low vision. The blind level of 23.91%. eye complications was negatively correlated with initial BCVA and prognosis BCVA. Ocular complications were associated with ocular complications. There was a positive correlation with recurrence. Conclusion: (1) the distribution of pigmented meningitis is mainly in young and middle-aged men, and the distribution of sex is different in different age groups. (2) the most common types of pigmented meningitis in this study, the second of total pigmented meningitis, the posterior, and the middle pigmented meningitis are rare. The cause of the disease is the anterior pigment membrane associated with seronegative vertebral joint lesions. Inflammation, VKH syndrome, glaucoma ciliary body syndrome mainly. Premeningitis is idiopathic, seronegative vertebral joint disease is common, total pigmented meningitis is idiopathic, VKH syndrome is dominant, and other types are mainly idiopathic. (3) visual acuity is damaged in different degrees in this study and has certain blindness. Pretreatment for prepigmented meningitis The prognosis of visual acuity after treatment is good, but there is still a blindness risk. In the middle, the visual recovery of the patients with post pigmented meningitis is limited and the total pigmented meningitis is easy to be blinded. (4) the recurrence rate of the middle aged men is more common, the recurrence rate of the anterior pigmented meningitis is the highest and the second is the total pigmented meningitis. The recurrence of the visual prognosis is affected by the recurrence, and the visual acuity of all types of pigmented meningitis is damaged. (5) there were more ocular complications in this study than in women, mainly for posterior synechia of the iris, complicated cataract, secondary glaucoma and different types of complications of ME.. The complications affected early diagnosis and prognosis of BCVA vision. The recurrence of the disease affected the occurrence of complications.

【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R773

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