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本文论述了青少年型关节炎与葡萄膜炎的关系。HLA-B27相关的脊椎关节炎儿童可伴发前葡萄膜炎。IgM类风湿因子阴性的青少年类风湿性关节炎(JRA)患者有20%并发双眼慢性非肉芽肿性前葡萄膜炎。JRA患者发生葡萄膜炎的危险因素有:女性、少数关节发病的关节炎、循环抗核抗体阳性和HLA-DW5及HLA-DPw2抗原阳性。关节炎患儿发病7年后很少再并发葡萄膜炎。葡萄膜炎的视力预后良好者占25%,一般者占50%,其余25%因并发性白内障或继发青光眼而较差。细胞毒素类药物的副作用较大,不宜用于治疗顽固性葡萄膜炎。继发性炎性青光眼的疗效不能令人满意,但晶体囊膜切开摘出术联合玻璃体切割术对并发性白内障的疗效较好。
This article discusses the relationship between juvenile arthritis and uveitis. Children with spondyloarthropathies associated with HLA-B27 may have anterior uveitis. 20% of patients with IgM rheumatoid factor-negative juvenile rheumatoid arthritis (JRA) have bilateral non-granulomatous anterior uveitis. The risk factors for uveitis in JRA patients were women, a few arthritic joints, circulating anti-nuclear antibodies and positive HLA-DW5 and HLA-DPw2 antigens. Arthritis rarely occurs in 7 years after the onset of uveitis. Good prognosis of uveitis 25% of eyesight, usually accounted for 50%, the remaining 25% due to complicated cataract or secondary glaucoma and poor. Side effects of cytotoxic drugs larger, should not be used to treat intractable uveitis. The efficacy of secondary inflammatory glaucoma is not satisfactory, but the crystal capsulotomy combined with vitrectomy for the treatment of complicated cataract better.