Vogt-小柳—原田综合征的临床治疗分析

发布时间：2018-05-03 09:19

本文选题：Vogt-小柳-原田综合征 + 葡萄膜炎　；参考：《石河子大学》2013年硕士论文

【摘要】：目的探讨Vogt-小柳-原田综合征（Vogt-Koyanagi-Harada sydrome，VKH）临床特点，诊断，治疗及治疗效果。方法收集2001年1月-2011年12月在我院就诊的20例39眼VKH患者的临床资料，对其眼部表现、全身症状、眼底荧光素血管造影（fundus fluorescein angiograghy，FFA），光学相干断层成像术（opticalcoherence tomography，OCT),超声生物显微镜（ultrasound biomicroscope UBM)和治疗方法，治疗结果和并发症的治疗进行回顾性分析。所有患者给予大剂量糖皮质激素治疗。结果该组病例中20例（39眼）均为初发患者，19例双眼发病，1例单眼发病。20例患者误诊为青光眼2例，急性视网膜色素上皮炎2例，视神经视网膜炎2例，中心性浆液性脉络膜视网膜病变1例。发病前有前驱症状者14例（70%），主要为头痛，恶心，呕吐。就诊时有眼外症状和体征者16例（80%），包括中枢神经系统异常、听力障碍、脱发和白癜风。FFA检查表现为斑驳状高荧光、视盘色染和多湖样荧光积存。所有患者给予大剂量糖皮质激素治疗，一周后20例患者的视力均有不同程度的改善。随访6个月，3例患者复发。结论前驱症状，临床病程，眼外表现及FFA等有助于Vogt-小柳-原田综合征的诊断，早期给予大剂量糖皮质激素治疗，绝大部分患者可控制炎症，，改善视力；但有复发倾向，严密观察，应长期随访。
[Abstract]:Objective to investigate the clinical features, diagnosis, treatment and therapeutic effect of Vogt-Koyanagi-Harada sydrome-VKH syndrome. Methods from January 2001 to December 2011, the clinical data of 39 eyes of 20 patients with VKH in our hospital from January 2001 to December 2011 were collected. Fundus fluorescein angiograghy FFAA, optical coherence tomography (Oct), ultrasound biomicroscopy (ultrasound biomicroscope), treatment methods, treatment results and complications were analyzed retrospectively. All patients were treated with high dose glucocorticoid. Results all of the 20 cases (39 eyes) were diagnosed as primary patients, 19 cases with binocular disease, 1 case with monocular disease. 20 cases were misdiagnosed as glaucoma, 2 cases were acute retinal pigment dermatitis, 2 cases were optic nerve retinitis, 2 cases were diagnosed as glaucoma, 2 cases were acute retinal pigment dermatitis, and 2 cases were optic neuroretinitis. One case of central serous chorioretinopathy. There were 14 cases with preemptive symptoms before onset, mainly headache, nausea and vomiting. There were 16 patients with extraocular symptoms and signs, including central nervous system abnormalities, hearing impairment, alopecia and vitiligo. FFA examination showed mottled hyperfluorescence, color staining of optic disc and accumulation of multilake fluorescence. All the patients were treated with high dose glucocorticoid, and the visual acuity of 20 patients improved in varying degrees after one week. Three patients with recurrence were followed up for 6 months. Conclusion prodromal symptoms, clinical course, extraocular manifestations and FFA are helpful to the diagnosis of Vogt- Xiaoliu-Harada syndrome, and early treatment with high dose glucocorticoid can control inflammation and improve visual acuity in most patients, but they tend to recur. Close observation should be followed up for a long time.
【学位授予单位】：石河子大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R773.9

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