眼眶炎性假瘤的临床病理特征分析及治疗效果观察

发布时间：2019-05-21 21:39

【摘要】：目的探讨淋巴细胞浸润型和硬化型眼眶炎性假瘤(orbital inflammatory pseudotumor,OIP)的临床病理特征,以及手术切除联合皮质类固醇治疗硬化型OIP的疗效。方法选择32例淋巴细胞浸润型和54例硬化型OIP患者,检测血清中Ig G4的水平,组织病理分析Ig G4阳性细胞的表达情况。淋巴细胞浸润型OIP患者采取糖皮质激素治疗,硬化型OIP患者均进行手术切除联合低剂量糖皮质激素治疗。结果硬化型患者血清Ig G4水平(1.87±0.38)g·L-1明显高于淋巴细胞浸润型OIP患者(0.93±0.21)g·L-1,病理学检查结果显示淋巴细胞浸润型OIP中有2例表现为浆细胞Ig G4阳性,硬化型OIP患者中有26例表现为浆细胞Ig G4表达阳性;淋巴检查细胞浸润型OIP患者随访3 a内有2例复发,硬化型OIP患者经手术切除联合糖皮质激素治疗后,随访3 a无一例复发。结论在对OIP患者进行诊治时,应首先根据临床症状和病理检查明确病变类型,对于硬化型OIP患者应尽早行手术治疗,术后联合长期低剂量皮质类固醇治疗可明显改善硬化型OIP患者的临床症状,提高治愈率。
[Abstract]:Objective to investigate the clinicopathological features of lymphocytes infiltrating and sclerosing orbital inflammatory pseudotumor (orbital inflammatory pseudotumor,OIP) and the efficacy of surgical resection combined with corticosteroids in the treatment of sclerosing OIP. Methods the levels of Ig G4 in serum were detected in 32 patients with infiltrating lymphocytes and 54 patients with sclerosing OIP. The expression of Ig G4 positive cells was analyzed by histology. Patients with lymphocytes infiltrating OIP were treated with glucocorticoid, and patients with sclerosing OIP were treated with surgical resection combined with low dose glucocorticoid. Results the level of serum Ig G4 in patients with sclerosis (1.87 卤0.38) g 路L-1 was significantly higher than that in patients with infiltrating OIP (0.93 卤0.21) g 路L-1. The results of pathological examination showed that the expression of plasma Ig G4 was positive in 2 cases of infiltrating OIP and 26 cases of sclerosing OIP. Two patients with lymphoid infiltrating OIP were followed up for 3 years. No recurrence occurred in patients with sclerosing OIP after surgical resection combined with glucocorticoid therapy. Conclusion in the diagnosis and treatment of OIP patients, the types of lesions should be determined according to the clinical symptoms and pathological examination, and the patients with sclerosing OIP should be treated surgically as soon as possible. Combined with long-term low dose corticosteroid treatment after operation can significantly improve the clinical symptoms and cure rate of sclerosing OIP patients.
【作者单位】：解放军第101医院眼科;河北医科大学第二医院;
【基金】：河北省卫生厅课题基金资助(编号:20130469)~~
【分类号】：R779.6

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