【作者】 杨静；

【导师】 张晓敏；

【作者基本信息】 天津医科大学 ， 临床医学（专业学位）， 2021， 博士

【摘要】 目的回顾性分析天津医科大学眼科医院2739例葡萄膜炎(uveitis)患者的临床资料,探讨本院葡萄膜炎者的流行病学特点以及患有相关全身疾病葡萄膜炎患者的特点。方法1.连续收集自2011年8月至2020年12月于天津医科大学眼科医院就诊的所有葡萄膜炎患者病例资料,筛选出2739例病历记录完整的葡萄膜炎患者病例资料进行回顾性分析。2.所有患者均由葡萄膜炎和免疫眼科同一位主任医师按照国际标准诊疗规范进行检查,并按照制定的病史采集问卷详细询问患者的眼病史和全身性疾病史。收集患者流行病学资料(性别、发病年龄、葡萄膜炎病因类型诊断、解剖诊断、居住地、所患相关全身疾病类型),对采集的数据进行分析。3.将患有相关全身疾病的葡萄膜炎患者与未患相关全身疾病的葡萄膜炎患者进行对比分析。结果1.自2011年8月至2020年12月于本院就诊的2739例各类葡萄膜炎患者中男性1307例(47.7%),女性1432例(52.3%),男性女性比例为1:1.10,女性患者略高于男性患者。就诊的患者绝大多数来自中国北方。双眼发病与单眼发病比例为1:1.67,单眼发病患者显著多于双眼发病的患者,且右眼和左眼的发病比例相近。2739例葡萄膜炎患者发病年龄中位数是42(30-55)岁,于40-49岁发病的患者最多。2.本中心2739例葡萄膜炎患者中前葡萄膜炎患者比例最高,其次为全葡萄膜炎和后葡萄膜炎,中间葡萄膜炎比例最低。特发性葡萄膜炎患者比例较高,非特发性葡萄膜炎患者中多数为非感染性葡萄膜炎。非感染性葡萄膜炎中比例最高的分别为强直性脊柱炎、Vogt-小柳原田综合征、Fuchs综合征、白塞氏病和青睫综合征。感染性葡萄膜炎中比例最高的为病毒性葡萄膜炎、结核性葡萄膜炎和梅毒性葡萄膜炎。本中心葡萄膜炎患者治疗结束后患眼的视力损害率和致盲率较低于既往文献报道。3.患有葡萄膜炎相关全身疾病的患者占所有患者的29.5%。其中比例最高的相关全身疾病分别为强直性脊柱炎和Vogt-小柳原田病。患有相关全身疾病的葡萄膜炎患者男性多于女性。总体于40-49岁发病的患者最多,其次是30-39岁发病的患者,80岁以上发病的患者最少。与未患有相关全身疾病的葡萄膜炎患者相比,葡萄膜炎相关全身疾病患者男性多发,单眼发病和双眼发病比例相当,解剖分类全葡萄膜炎的比例最高。结论1.于本中心就诊的葡萄膜炎患者绝大多数来自中国北方,以30-50岁的中青年为主,女性患者较多,多为单眼发病,视力预后良好。2.本研究中葡萄膜炎按解剖分类以前葡萄膜炎为主,按病因分类以特发性葡萄膜炎为主,而非特发性葡萄膜炎患者中,多数为非感染性葡萄膜炎。3.本中心患有葡萄膜炎相关全身疾病的患者比例为29.5%,以40-49岁的中年为主,男性患者较多,多为单眼发病,以全葡萄膜炎为主。更多还原

【Abstract】 ObjectiveRetrospective analysis of 2739 patients with uveitis in Tianjin Medical University Eye Hospital to explore the epidemiological profile of all uveitis cases and the characteristics of uveitis patients with associated systemic diseases.Methods1.The clinical data of all patients with uveitis who visited Tianjin Medical University Eye Hospital from August 2011 to December 2020 were collected,and2739 cases of uveitis with complete medical records were selected for retrospectively analyzed.2.All patients were examined by the same chief doctors of the department of uveitis& ocular immunology according to the international standard medical practice,and a detailed history of was taken according to the medical history questionnaire.Epidemiological data(gender,onset age,etiological diagnosis,anatomical diagnosis,residence,type of associated systemic disease)were collected to explore the epidemiological profile of all patients with uveitis.The rate of visual impairment and blindness in our center was lower than previously reported in the literature.3.Analyze the uveitis patients with associated systemic diseases in compared with those without associated systemic diseases.Results1.2739 patients with various types of uveitis were collected at our hospital from August 2011 to December 2020,of whom 1307(47.7%)male and 1432(52.3%)female.The ratio of male to female was 1:1.10 and there was a slightly higher number of female patients than male patients.The vast majority of patients attending the clinic were from northern China.The number of patients with unilateral uveitis was significantly higher than that of patients with bilateral uveitis,and the ratio of bilateral uveitis to unilateral uveitis was 1:1.67.The proportion of patients with right and left eyes was similar.The median age of the 2739 patients with uveitis was 42(30-55)years,with the greatest number of patients aged 40-49 years.2.The 2739 patients with uveitis in our center had the highest proportion of anterior uveitis,followed by panuveitis and posterior uveitis,and the lowest proportion of intermediate uveitis.The number of patients with idiopathic uveitis was higher,and the majority of patients with non-idiopathic uveitis had non-infectious uveitis.The highest proportions of noninfectious uveitis were ankylosing spondylitis,VKH,Fuchs syndrome,leukoaraiosis,and cyanociliary syndrome,respectively.The highest rates of infectious uveitis were viral uveitis,tuberculous uveitis,and syphilitic uveitis.3.Patients with uveitis-related systemic diseases accounted for 29.5% of all patients.The highest proportion of associated systemic diseases were ankylosing spondylitis and VKH respectively.More men than women had uveitis with associated systemic disease.The highest number of patients with uveitis was in the 40-49 years group,followed by the 30-39 years group,and the lowest number of patients over 80.The proportion of patients with systemic disease was higher in males than females,the proportion of patients with bilateral disease was higher,the proportion of patients with panuveitis was highest in the anatomical classification.Conclusion1.The vast majority of patients attending the clinic were from northern China.The highest proportion of patients were between the ages of 30 and 49 years.The prevalence was significantly higher in females than in males,and also higher in unilateral uveitis patients compared with bilateral cases.After treatment the visual prognosis is generally good.2.In this study,all patients with uveitis in our center had the highest proportion of anterior uveitis.The number of patients with idiopathic uveitis was higher,and the majority of patients with non-idiopathic uveitis had non-infectious uveitis.3.The uveitis patients with associated systemic diseases accounted for 29.5% of all patients.The highest proportion of these patients were between the ages of 40 and 49 years.The prevalence was significantly higher in males than in females,and also higher in unilateral uveitis patients compared with bilateral cases,and was highest in panuveitis.更多还原