环孢素联合糖皮质激素治疗特发性全葡萄膜炎的临床应用研究

发布时间：2018-06-28 04:12

本文选题：特发性全葡萄膜炎 + 环孢素　；参考：《郑州大学》2011年硕士论文

【摘要】：背景和目的特发性葡萄膜炎是指病因不明又不能归入特定类型的累及眼部葡萄膜、视网膜、视网膜血管以及玻璃体的炎症,约占我国葡萄膜炎发病患者的40%。其中特发性全葡萄膜炎病程复杂,临床以糖皮质激素治疗为主,有一定的治疗效果,但容易复发,且致盲率高。目前对于顽固性特发性全葡萄膜炎尚无特定的治疗方案和有效药物,为了解决这一临床难题以及观察联合环孢素治疗特发性全葡萄膜炎的临床特点及其治疗效果和毒副作用,我们归纳分析了56例在我院联合环孢素治疗的顽固性特发性全葡萄膜炎患者的临床资料进行研究。方法回顾性分析2008年1月～2010年1月在我院眼科住院和门诊治疗的顽固性特发性全葡萄膜炎患者56例(72眼),其中男31例(39眼),女25例(33眼)；年龄6岁～71岁,平均43.52岁,将其随机分为两组,第一组：男16例(19眼),女13例(15眼),单纯用糖皮质激素治疗；第二组：男15例(20眼),女12眼(18眼),联合环孢素治疗,分别记录患者治疗前后的视力、炎症情况和药物毒副作用,将所得结果进行统计学分析以评价其治疗效果和毒副作用。统计学处理采用SPSS17.0软件进行统计学分析,计数资料采用卡方检验比较,检验水准为α=0.05；计量资料采用t检验,检验水准为α=0.05。结果对照组与治疗组治疗前后的疗效及视力均提高,具有统计学意义,说明两者均有临床治疗效果；治疗后的视力,治疗组较对照组提高更明显,具有统计学意义,说明联合环孢素治疗临床效果优于单纯应用糖皮质激素治疗。两组治疗后的毒副作用观察指标值较治疗前均有所升高,但两组间相比较无统计学意义,说明两种药物对身体都有毒副作用,但治疗组相对于对照组未发现有严重的毒副作用,经对症治疗后均可好转。结论对于顽固性特发性全葡萄膜炎患者,排除禁忌症后： 1.使用环孢素联合糖皮质激素较单纯应用糖皮质激素治疗临床效果良好； 2.经严格监测各项化验检查和积极的预防措施,无严重毒副作用发生； 3.本研究也为首次发病的较严重的特发性全葡萄膜炎或其他类型的葡萄膜炎应用环孢素治疗提供了临床依据。
[Abstract]:Background and objective Idiopathic uveitis refers to inflammation involving ocular uvea retinal vessels and vitreous which has unknown etiology and cannot be classified into specific types. It accounts for 40% of the patients with uveitis in China. The course of idiopathic total uveitis is complicated, the main clinical treatment is glucocorticoid, it has certain therapeutic effect, but it is easy to recur, and the rate of blindness is high. At present, there is no specific treatment plan and effective drug for refractory idiopathic total uveitis. In order to solve this clinical problem and to observe the clinical characteristics, therapeutic effect and side effects of combined cyclosporine in treating idiopathic total uveitis, The clinical data of 56 patients with refractory idiopathic uveitis treated with cyclosporine in our hospital were summarized and analyzed. Methods from January 2008 to January 2010, 56 patients (72 eyes) with refractory idiopathic uveitis were retrospectively analyzed, including 31 males (39 eyes) and 25 females (33 eyes), aged from 6 to 71 years old. The average age of 43.52 years was 43.52 years. The first group was divided into two groups: 16 males (19 eyes) and 13 females (15 eyes) treated with glucocorticoid alone, the second group: 15 males (20 eyes) and 12 eyes (18 eyes) treated with cyclosporine. The visual acuity, inflammation and side effects before and after treatment were recorded, and the results were statistically analyzed to evaluate the therapeutic effect and side effects. SPSS 17.0 software was used for statistical analysis, the counting data was compared by chi-square test, the test level was 伪 -0.05, and the measurement data was t-test, the test level was 伪 -0.05. Results the curative effect and visual acuity of the control group and the treatment group were improved before and after treatment, which showed that both of them had clinical therapeutic effect, and the visual acuity after treatment in the treatment group was significantly higher than that in the control group. The clinical effect of combined cyclosporine is better than that of glucocorticoid alone. The observation index values of side effects after treatment in both groups were higher than those before treatment, but there was no statistical significance between the two groups, indicating that both drugs had toxic side effects on the body, but no serious side effects were found in the treatment group compared with the control group. After the symptomatic treatment can be improved. Conclusion for the patients with refractory idiopathic total uveitis, the contraindications should be eliminated: 1. The clinical effect of cyclosporine combined with glucocorticoid was better than that of glucocorticoid alone. 2. After strict monitoring of all laboratory tests and active preventive measures, no serious side effects occurred; 3. This study also provides a clinical basis for the first time severe idiopathic total uveitis or other types of uveitis treated with cyclosporine.
【学位授予单位】：郑州大学
【学位级别】：硕士
【学位授予年份】：2011
【分类号】：R773

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