儿童急性视神经炎的临床特征和疗效分析

发布时间：2019-01-09 11:29

【摘要】：目的:探讨儿童急性视神经炎的临床特征和糖皮质激素大剂量冲击治疗的疗效。方法:收集2006-06/2014-06南京医科大学附属南京儿童医院眼科收治的58例16岁以下急性视神经炎患儿的临床资料,研究大剂量甲基强的松龙冲击治疗前后患眼视力、眼底检查和瞳孔大小等变化情况,以评估治疗的效果。结果:患儿58例有103眼患病,病因明确与感染有关占55.2%,1例2眼进展为播散性脑脊髓炎,其余病因不明。治疗3mo后80.5%患眼视力恢复到0.7以上,其中约2/3视力恢复到1.0以上,低于0.1的仅为3.9%;治疗1mo时视力、视野、VEP检查结果均显示无改善者2眼(1.9%),激素大剂量冲击治疗的治愈率60.2%,总体有效率为98.1%。结论:在儿童视神经炎中,感染是首发病因,应用大剂量糖皮质激素冲击治疗效果显著,值得推广。
[Abstract]:Objective: to investigate the clinical features of acute optic neuritis in children and the effect of high dose shock therapy with glucocorticoid. Methods: the clinical data of 58 children under 16 years old with acute optic neuritis admitted to Nanjing Children's Hospital affiliated to Nanjing Medical University from 2006 to June 2014-06 were collected and the visual acuity of the affected eyes before and after high-dose methylprednisolone shock therapy were studied. Changes in fundus examination and pupil size were used to evaluate the efficacy of the treatment. Results: 103 eyes of 58 cases were infected. The etiology was clearly related to infection. One case (2 eyes) developed disseminated encephalomyelitis. The other causes were unknown. After treatment with 3mo, the visual acuity of 80.5% of the affected eyes recovered to more than 0.7, of which about 2 / 3 of the visual acuity recovered to more than 1.0, and that of less than 0.1 was only 3.9. The visual acuity, visual field and VEP showed no improvement in 2 eyes (1.9%) during 1mo treatment. The cure rate was 60.2in high-dose impulse therapy, and the total effective rate was 98.1%. Conclusion: infection is the first cause of optic neuritis in children. The effect of high dose glucocorticoid shock therapy is remarkable and worth popularizing.
【作者单位】：南京医科大学附属南京儿童医院眼科;
【基金】：国家自然科学基金资助项目(No.8140030101) 江苏省自然科学基金资助项目(No.BK20140088)~~
【分类号】：R774.6

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