發(fā)布時間：2018-05-07 18:59

  本文選題：色素膜炎 + 病因�。� 參考：《吉林大學(xué)》2017年碩士論文

【摘要】：目的:分析探討色素膜炎的發(fā)病類型、性別、年齡、病因、視力、復(fù)發(fā)及并發(fā)癥分布特征。方法:收集自2015年9月至2016年12月就診我院的色素膜炎144例184眼資料,記錄性別、年齡、視力、臨床診斷、復(fù)發(fā)及并發(fā)癥等臨床資料,采用統(tǒng)計學(xué)方法進行分析。結(jié)果:(1)疾病類型分布:按發(fā)病部位分前、中間、后、全色素膜炎,分別占59.72%、2.78%、8.33%、29.17%。根據(jù)病程分急性、慢性及復(fù)發(fā)性,分別為60.42%、39.58%、45.83%。(2)性別分布:患者男女比為1.76:1。前色素膜炎中男女比為1.39:1,中間、后色素膜炎均為男性,全色素膜炎男女比為1.33:1。(3)年齡分布:發(fā)病年齡在17-83歲,平均為(43.44±15.55)歲。其中前、中間、后、全色素膜炎分別為(41.49±15.98)歲、(38±3.46)歲、(36.5±16.51)歲、(49.95±13.09)歲。發(fā)病年齡小于20歲者6.94%,20-60歲年齡段者77.78%,60歲以上者(包括60歲)15.28%。(4)病因分布:患者病因明確者50%。前色素膜炎以特發(fā)性(29.17%)、血清陰性椎關(guān)節(jié)病變伴發(fā)(11.11%)、青光眼睫狀體炎綜合征(6.94%)為主,中間色素膜炎均為特發(fā)性,后色素膜炎以特發(fā)性(5.56%)為主,全色素膜炎患者以特發(fā)性(12.5%)、VKH綜合征(9.72%)為主。(5)視力分布:36.96%的患眼初診BCVA0.5,27.17%為視力損害,20.65%處于低視力水平,15.22%為盲水平。經(jīng)藥物治療,預(yù)后視力,65.21%的患眼BCVA0.5,11.96%為視力損害,14.13%處于低視力水平,盲水平8.7%。前色素膜炎預(yù)后BCVA0.5眼占78%,視力損害眼8%,低視力水平眼8%,盲水平眼6%;中間色素膜炎預(yù)后BCVA均在視力損害范圍;后色素膜炎預(yù)后BCVA0.5眼占55.56%,視力損害眼33.33%,低視力水平眼11.11%;全色素膜炎預(yù)后BCVA0.5眼占51.61%,視力損害眼9.68%,低視力水平眼22.58%,盲水平眼16.13%。雙變量相關(guān)性分析預(yù)后BCVA與初診BCVA呈正相關(guān)。(6)復(fù)發(fā):平均復(fù)發(fā)時間為43.2個月,男女復(fù)發(fā)比為2.67:1,復(fù)發(fā)平均年齡為(46.64±14.60)歲。前、后、全色素膜炎復(fù)發(fā)率分別為39.53%、83.33%、53.38%,中間色素膜炎未見復(fù)發(fā)。復(fù)發(fā)患眼初診BCVA0.5者13.04%,視力損害眼18.48%,低視力水平眼8.70%,盲水平眼8.70%。經(jīng)治療后終末視力,BCVA0.5者25%,視力損害眼7.61%,低視力水平眼9.78%,盲水平眼5.43%。復(fù)發(fā)與預(yù)后BCVA呈負(fù)相關(guān)性。(7)并發(fā)癥:眼部并發(fā)癥患者男女性別比為2:1。50%患者出現(xiàn)眼部并發(fā)癥,以ME(33.33%)、并發(fā)性白內(nèi)障(25%)、虹膜后粘連(25%)、繼發(fā)性青光眼(19.44%)為主。前色素膜炎以并發(fā)性白內(nèi)障(18.60%)、繼發(fā)性青光眼(11.63%)、虹膜后粘連(9.30%)為主,后色素膜炎以ME(66.66%)為主,全色素膜炎以ME(33.33%)、虹膜后粘連(19.05%)、黃斑前膜(14.29%)為主。伴有眼部并發(fā)癥患者初診時,23.91%的患眼BCVA0.5,32.61%為視力損害,19.57%處于低視力水平,盲水平23.91%。經(jīng)治療后預(yù)后視力,45.64%的患眼BCVA0.5,19.57%為視力損害,19.57%處于低視力水平,盲水平23.91%。眼部并發(fā)癥與初診BCVA及預(yù)后BCVA呈負(fù)相關(guān),眼部并發(fā)癥與復(fù)發(fā)呈正相關(guān)。結(jié)論:(1)眼色素膜炎以中青年男性為主,不同年齡段、不同類型性別分布不同。(2)本研究中發(fā)病類型以前色素膜炎最常見,全色素膜炎次之,后部、中間色素膜炎少見。病因明確者為以血清陰性椎關(guān)節(jié)病變伴發(fā)的前色素膜炎、VKH綜合征、青光眼睫狀體炎綜合征為主。前色素膜炎中以特發(fā)性、血清陰性椎關(guān)節(jié)病變伴發(fā)常見,全色素膜炎以特發(fā)性、VKH綜合征為主,其他類型均以特發(fā)性為主。(3)本研究中患眼視力不同程度受損,且具有一定致盲性。前色素膜炎經(jīng)治療后視力預(yù)后良好,但依然存在致盲風(fēng)險;中間、后色素膜炎患者視力恢復(fù)有限;全色素膜炎易致盲。(4)本研究中復(fù)發(fā)以中年男性多見,前色素膜炎復(fù)發(fā)率最高,其次為全色素膜炎。復(fù)發(fā)影響視力預(yù)后,對各類型色素膜炎視力均具有一定損傷。(5)本研究中眼部并發(fā)癥男性多于女性,主要為虹膜后粘連、并發(fā)性白內(nèi)障、繼發(fā)性青光眼及ME。不同類型并發(fā)癥因型而異。并發(fā)癥影響初診及預(yù)后BCVA視力。疾病的復(fù)發(fā)影響并發(fā)癥的發(fā)生。
[Abstract]:Objective: to analyze the incidence of pigmented meningitis, sex, age, etiology, visual acuity, recurrence and complications. Methods: 184 eyes of 144 cases of pigmented meningitis in our hospital from September 2015 to December 2016 were collected, and the clinical data of sex, age, vision, clinical diagnosis, recurrence and complications were recorded, and statistical methods were used. Analysis. Results: (1) distribution of disease types: according to the position of the disease before, middle, after, total pigmented meningitis, accounted for 59.72%, 2.78%, 8.33%, 29.17%. according to the course of acute, chronic and recurrent, respectively 60.42%, 39.58%, 45.83%. (2) sex distribution: the ratio of men and women to 1.76:1. pre pigmented meningitis is 1.39:1, middle, and post pigmented meningitis is male Sex, total pigmented meningitis is 1.33:1. (3) age distribution: the age of onset is 17-83 years, and the average age is (43.44 + 15.55) years. Among them, the former, middle, and later, (41.49 + 15.98) years, (38 + 3.46) years, (36.5 + 16.51) years, (49.95 + 13.09) years old. The distribution of 15.28%. (4) etiology: the patients with clear etiology, 50%. pre pigmented meningitis (29.17%), seronegative vertebral joint lesions (11.11%), glaucoma ciliary body syndrome (6.94%), middle pigmented meningitis are idiopathic, post pigmented meningitis is idiopathic (5.56%), and all pigmented meningitis patients with idiopathic (12.5%), VKH synthesis Sign (9.72%) mainly. (5) visual acuity distribution: 36.96% of the first diagnosed BCVA0.5,27.17% were visual impairment, 20.65% were low vision and 15.22% were blind. After drug treatment, the prognosis of the eyes, 65.21% of the eyes were impaired in visual acuity, 14.13% were in low vision, and the prognosis of BCVA0.5 eyes was 78% and visual impairment after the blind level of 8.7%. premeningitis. Eye 8%, low vision horizontal eye 8%, blind horizontal eye 6%, intermediate pigmented meningitis in the range of BCVA in visual impairment, posterior pigmented meningitis in BCVA0.5 eyes, 55.56%, visual impairment 33.33%, and low vision, 11.11%, 51.61% in BCVA0.5 eyes, 9.68% in visual impairment, 22.58% in low vision level, and 16.13%. bivariate blind in horizontal eyes. There was a positive correlation between the prognosis BCVA and the first diagnosis of BCVA. (6) recurrence: the average recurrence time was 43.2 months, the recurrence ratio of men and women was 2.67:1, the average age of relapse was (46.64 + 14.60) years. The recurrence rate of the total pigmented meningitis was 39.53%, 83.33%, 53.38%, and the intermediate pigmented meningitis was not recurred. The recurrence rate was 13.04% and the visual impairment. Eye 18.48%, low vision level 8.70%, blind horizontal eye 8.70%. after treatment of final visual acuity, BCVA0.5 25%, visual impairment 7.61%, low vision 9.78%, blind level of 5.43%. recurrence and the prognosis BCVA negative correlation. (7) complications: eye complications of men and women and sex ratio of patients with 2:1.50% eye complications, ME (33.33%), concurrence Cataract (25%), posterior synechia (25%), secondary glaucoma (19.44%). Anterior pigmented membrane inflammation (18.60%), secondary glaucoma (11.63%), posterior synechia (9.30%), ME (66.66%), full pigmented meningitis with ME (33.33%), posterior synechia (19.05%), and macular membrane (14.29%). At the initial diagnosis of complications, 23.91% of the patients had visual impairment BCVA0.5,32.61% and 19.57% in low vision. Blind level of 23.91%. was treated with visual acuity after treatment. 45.64% of the patients had visual impairment with BCVA0.5,19.57%, 19.57% were in low vision. The blind level of 23.91%. eye complications was negatively correlated with initial BCVA and prognosis BCVA. Ocular complications were associated with ocular complications. There was a positive correlation with recurrence. Conclusion: (1) the distribution of pigmented meningitis is mainly in young and middle-aged men, and the distribution of sex is different in different age groups. (2) the most common types of pigmented meningitis in this study, the second of total pigmented meningitis, the posterior, and the middle pigmented meningitis are rare. The cause of the disease is the anterior pigment membrane associated with seronegative vertebral joint lesions. Inflammation, VKH syndrome, glaucoma ciliary body syndrome mainly. Premeningitis is idiopathic, seronegative vertebral joint disease is common, total pigmented meningitis is idiopathic, VKH syndrome is dominant, and other types are mainly idiopathic. (3) visual acuity is damaged in different degrees in this study and has certain blindness. Pretreatment for prepigmented meningitis The prognosis of visual acuity after treatment is good, but there is still a blindness risk. In the middle, the visual recovery of the patients with post pigmented meningitis is limited and the total pigmented meningitis is easy to be blinded. (4) the recurrence rate of the middle aged men is more common, the recurrence rate of the anterior pigmented meningitis is the highest and the second is the total pigmented meningitis. The recurrence of the visual prognosis is affected by the recurrence, and the visual acuity of all types of pigmented meningitis is damaged. (5) there were more ocular complications in this study than in women, mainly for posterior synechia of the iris, complicated cataract, secondary glaucoma and different types of complications of ME.. The complications affected early diagnosis and prognosis of BCVA vision. The recurrence of the disease affected the occurrence of complications.

【學(xué)位授予單位】：吉林大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R773

【相似文獻】

相關(guān)期刊論文 前10條

1 高永慶 ,王曉陽;老年人色素膜炎[J];國外醫(yī)學(xué).眼科學(xué)分冊;1983年04期

2 孫世珉;;以環(huán)境適應(yīng)學(xué)研究色素膜炎[J];醫(yī)學(xué)文摘(眼科學(xué));1965年03期

3 劉艾武;彭陶東;田繼良;劉輝萍;;140例色素膜炎的辨證分型治療[J];中醫(yī)臨床與保健;1993年02期

4 李玉冰，，狄淑煥;色素膜炎的中醫(yī)藥治療[J];中西醫(yī)結(jié)合眼科雜志;1995年01期

5 付少山,張長銀,梁榮華;中醫(yī)藥為主治療色素膜炎26例[J];四川中醫(yī);1998年05期

6 李克江;賽撲達(dá)治療色素膜炎療效觀察[J];中國實用眼科雜志;2002年11期

7 羅成仁;;病毒血癥引起單純皰疹性色素膜炎[J];國外醫(yī)學(xué)參考資料.眼科學(xué)分冊;1979年02期

8 CharDH ,毛樹章 ,鮑麗玲;色素膜炎中的免疫復(fù)合物[J];國外醫(yī)學(xué).眼科學(xué)分冊;1980年02期

9 章蘭仙;免疫療法治療色素膜炎的初步體會[J];西北國防醫(yī)學(xué)雜志;1982年02期

10 肖潤華;楊海連;楊會仙;凌瑞英;左柏慶;孟昭榮;張瑩;;應(yīng)用激素治療色素膜炎途徑的探討[J];錦州醫(yī)學(xué)院學(xué)報;1982年04期

相關(guān)會議論文 前1條

1 趙俊宏;呂沛霖;趙平;;中西醫(yī)結(jié)合治療色素膜炎性白內(nèi)障的初步臨床觀察[A];第十四屆西北五省眼科學(xué)術(shù)大會論文集[C];2013年

相關(guān)碩士學(xué)位論文 前1條

1 陳麗麗;色素膜炎的病因及臨床特征分析[D];吉林大學(xué);2017年

本文編號：1858087