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目的:探讨TPA阳性患者人工晶状体植入术后葡萄膜炎的成因及治疗方法。方法:对13例TPA阳性的白内障患者的发病时间、诱因、前房渗出物和治疗情况进行观察。结果:患者年龄偏大,均>50岁,多数在70岁以上;女性多于男性;发病时间均在术后第1天发病,病程7~30 d;青霉素及皮质类固醇治疗有效。结论:TPA阳性患者白内障术后的葡萄膜炎可能是有免疫复合物介导的变态反应,是由于晶状体蛋白与梅毒螺旋体特异性抗体及反应素结合诱发的葡萄膜炎性反应。
Objective: To investigate the causes and treatment of uveitis after intraocular lens implantation in TPA positive patients. Methods: Thirteen cases of TPA-positive cataract patients with onset time, incentives, anterior chamber exudate and treatment were observed. Results: Patients were older than 50 years old, most of whom were over 70 years old. There were more women than men. The onset time was on the first day after the operation with a course of 7-30 days. Penicillin and corticosteroids were effective. CONCLUSIONS: Uveitis after TPA-positive patients may be immune complex-mediated allergic reaction due to the uveitis reaction induced by the combination of crystallin and Treponema pallidum-specific antibody and reactive element.