【摘要】：目的了解兒童視神經(jīng)炎(ON)患者的流行病學及臨床特征,為ON患兒的早期診療提供科學依據(jù)。方法收集2010年11月~2014年1月就診于全國17家醫(yī)院的275例(414眼)兒童ON患者的臨床資料,記錄其人口學特征、病因分型、前驅病史、臨床癥狀、眼科和影像學檢查結果及預后情況,進行回顧性分析。結果 275例患者中男女性別發(fā)病比為1∶1.24。發(fā)病年齡為2~15歲,以6歲及以上為主(94.5%)。兒童ON發(fā)病主要集中在秋、冬季節(jié)(64.4%),夏季較少(11.6%)。216例(78.5%)患者符合特發(fā)性ON診斷標準。單眼發(fā)病者136例(49.5%),雙眼同時或相繼發(fā)病者139例(50.5%)。80例(29.1%)患者在發(fā)病前3個月內有前驅病史。270例(377眼)進行了視力檢查,201眼(53.3%)視力0.1;271例(406眼)進行了眼底鏡檢查,299眼(73.6%)出現(xiàn)視神經(jīng)乳頭炎。視神經(jīng)、脊髓和頭顱3個部位在MRI檢查中出現(xiàn)異常的比例分別為55.0%、41.2%和25.4%,差異有統(tǒng)計學意義(χ~2=29.602,P0.013)。隨訪82眼發(fā)病3個月后的最佳恢復情況,71眼(86.6%)的視力得到恢復。結論兒童ON好發(fā)于6歲及以上的女性,以特發(fā)性ON為最常見的病因類型,單眼和雙眼發(fā)病比例接近,以視力下降嚴重、視神經(jīng)乳頭炎為主要的臨床特征,預后效果較好。
[Abstract]:Objective to investigate the epidemiological and clinical features of children with optic neuritis (ON) in order to provide scientific basis for early diagnosis and treatment of ON. Methods Clinical data of 275 children (414 eyes) with ON from November 2010 to January 2014 in 17 hospitals in China were collected, and their demographic characteristics, etiological classification, history of previous disease and clinical symptoms were recorded. The results and prognosis of ophthalmology and imaging examination were analyzed retrospectively. Results the ratio of male to female was 1: 1.24 in 275 patients. The age of onset was 2 or 15 years old, mainly aged 6 years and above (94.5%). The incidence of ON in children was mainly in autumn, winter (64.4%) and summer (11.6%). 216 cases (78.5%) met the diagnostic criteria of idiopathic ON. 136 cases (49.5%) developed monocular disease, 139 cases (50.5%) occurred simultaneously or sequentially. 80 cases (29.1%) had a history of prodromal disease within 3 months before onset. 270 cases (377 eyes) underwent visual acuity examination, 201 eyes (53.3%) underwent fundus examination in 271 cases (406 eyes), and 299 eyes (299 eyes) had fundus examination. The incidence of optic papilltis was 73.6%. The abnormal rates of optic nerve, spinal cord and skull in MRI were 51.2% and 25.4%, respectively. The difference was statistically significant (蠂 ~ 2 ~ (29.602) P 0.013). 82 eyes were followed up for 3 months. 71 eyes (86.6%) had recovered their visual acuity. Conclusion ON in children is more common in women aged 6 years or older. Idiopathic ON is the most common etiologic type. The incidence of monocular and binocular diseases is similar, the visual acuity is serious and optic papillitis is the main clinical feature, and the prognosis is good.
【作者單位】： 北京大學公共衛(wèi)生學院流行病與衛(wèi)生統(tǒng)計學系;北京市疾病預防控制中心;首都醫(yī)科大學附屬北京同仁醫(yī)院神經(jīng)內科;中國人民解放軍總醫(yī)院眼科中心;
【基金】：國家科技支撐計劃項目(2012BAI08B06)
【分類號】：R774.61
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本文編號：2262699