论文部分内容阅读
目的 分析观察Vogt Koyanagi Harada(VKH)综合征患者的治疗方法和效果 ,寻找理想的治疗方案。方法 对 1996年 1月至 2 0 0 0年 12月在中山眼科中心葡萄膜炎专科确诊为VKH综合征 ,并经系统治疗及随访≥ 1年的 82例 (16 4只眼 )患者的资料进行分析。其中 2 8例 (5 6只眼 )为初发性患者 ,糖皮质激素治疗≥ 1年 ;5 4例 (10 8只眼 )为复发性患者 (外院间断性糖皮质激素治疗 ) ,用苯丁酸氮芥治疗≥ 1年 ;所有患者均联合中药治疗 ;将外院间断性糖皮质激素治疗的 5 4例患者与本院系统性治疗的 2 8例初发性患者资料进行对比分析。结果 2 8例初发性葡萄膜炎患者经系统的糖皮质激素治疗≥ 1年 ,视力均显著提高 ;96 4 %患者的葡萄膜炎完全控制。 5 4例复发性患者经苯丁酸氮芥治疗≥ 1年后 ,视力有不同程度增加者 95只眼 (88 0 % ) ;葡萄膜炎完全控制者 5 1例 (94 4 % ) ;5 4例外院间断性大剂量行糖皮质激素治疗者 ,葡萄膜炎均有复发或炎症持续存在 ,且其视力明显低于系统应用糖皮质激素或苯丁酸氮芥治疗后的视力。结论 初发性VKH综合征患者应给予足量及长期的糖皮质激素治疗 ;对复发患者 ,苯丁酸氮芥是一种有效的药物 ;中药在促进葡萄膜炎的恢复和减少免疫抑制剂的副作用中可能有一定的作用
Objective To analyze the treatment and effect of Vogt Koyanagi Harada (VKH) syndrome in order to find the ideal treatment. Methods From January 1996 to December 2000, 82 patients (164 eyes) with VKH syndrome diagnosed by Department of Ophthalmology, Zhongshan Eye Center and underwent systemic therapy and follow-up ≥ 1 year analysis. Among them, 28 (56 eyes) were newly diagnosed and glucocorticoid was treated for more than 1 year. Fifty-four (108 eyes) were recurrent (outside hospital intermittent glucocorticoid treatment) Acid nitrogen mustard for ≥ 1 year; all patients were treated with traditional Chinese medicine; 54 cases of intermittent glucocorticoid treatment of external hospital and 28 cases of primary treatment of systemic treatment in our hospital were compared. Results 28 cases of patients with primary uveitis were treated with systematic glucocorticoid therapy for ≥1 years. Visual acuity was significantly improved. Uveitis was completely controlled in 96 4% of the patients. In 5 of 4 recurrent patients, 95 eyes (88 0%) had visual acuity increased by chlorambucil for 1 year or more, 51 cases (94 4%) had complete control of uveitis, 54 In exceptional hospital intermittent large doses of glucocorticoid therapy, uveitis recurrence or inflammation persisted, and its visual acuity was significantly lower than the system of glucocorticoid or chlorambucil treatment of visual acuity. Conclusions Patients with VKH syndrome should be given adequate and long-term glucocorticoid therapy, and chlorambucil is an effective drug in patients with recurrent VKH syndrome. Traditional Chinese medicine can promote recovery of uveitis and reduce immunosuppressive agents Side effects may have a role