【摘要】：目的:探討兒童急性視神經(jīng)炎的臨床特征和糖皮質激素大劑量沖擊治療的療效。方法:收集2006-06/2014-06南京醫(yī)科大學附屬南京兒童醫(yī)院眼科收治的58例16歲以下急性視神經(jīng)炎患兒的臨床資料,研究大劑量甲基強的松龍沖擊治療前后患眼視力、眼底檢查和瞳孔大小等變化情況,以評估治療的效果。結果:患兒58例有103眼患病,病因明確與感染有關占55.2%,1例2眼進展為播散性腦脊髓炎,其余病因不明。治療3mo后80.5%患眼視力恢復到0.7以上,其中約2/3視力恢復到1.0以上,低于0.1的僅為3.9%;治療1mo時視力、視野、VEP檢查結果均顯示無改善者2眼(1.9%),激素大劑量沖擊治療的治愈率60.2%,總體有效率為98.1%。結論:在兒童視神經(jīng)炎中,感染是首發(fā)病因,應用大劑量糖皮質激素沖擊治療效果顯著,值得推廣。
[Abstract]:Objective: to investigate the clinical features of acute optic neuritis in children and the effect of high dose shock therapy with glucocorticoid. Methods: the clinical data of 58 children under 16 years old with acute optic neuritis admitted to Nanjing Children's Hospital affiliated to Nanjing Medical University from 2006 to June 2014-06 were collected and the visual acuity of the affected eyes before and after high-dose methylprednisolone shock therapy were studied. Changes in fundus examination and pupil size were used to evaluate the efficacy of the treatment. Results: 103 eyes of 58 cases were infected. The etiology was clearly related to infection. One case (2 eyes) developed disseminated encephalomyelitis. The other causes were unknown. After treatment with 3mo, the visual acuity of 80.5% of the affected eyes recovered to more than 0.7, of which about 2 / 3 of the visual acuity recovered to more than 1.0, and that of less than 0.1 was only 3.9. The visual acuity, visual field and VEP showed no improvement in 2 eyes (1.9%) during 1mo treatment. The cure rate was 60.2in high-dose impulse therapy, and the total effective rate was 98.1%. Conclusion: infection is the first cause of optic neuritis in children. The effect of high dose glucocorticoid shock therapy is remarkable and worth popularizing.
【作者單位】： 南京醫(yī)科大學附屬南京兒童醫(yī)院眼科;
【基金】：國家自然科學基金資助項目(No.8140030101) 江蘇省自然科學基金資助項目(No.BK20140088)~~
【分類號】：R774.6

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