【摘要】 <正> 内因性色素膜炎是比较常见的眼病,色素膜本身富有血管,各种细菌、病毒、毒素以及致敏物质等致病因素,易通过血流达到此处,对全身疾病产生炎性反应,罹病率也高。色素膜炎发病可急可慢,一般病程较长,易于复发,严重破坏眼球的生理功能和组织结构,如治疗不当,可严重地影响视力,每因虹膜后粘连、瞳孔闭锁、继发性青光眼、饼发性白内障等等导致失明。居致盲原因的第五、六位。由于色素膜炎病因极为复杂,且治疗困难,已成为眼科重要课题之一。国内有关内因性色素膜炎病例的临床分析,虽有零星散在的报导,但缺乏系统的分析报告,为此我们收集了自71年5月至81年4月住院病例及部分(有病历记载的)门诊病例共278例351眼内因性色素膜炎,进行临床分析,现将其结果报告于下:更多还原

【Abstract】 278 cases (351 eyes) of endogenous uveitis seen during the recent 10 years (1971—81) were reviewed. There were 166 male patients (59.7%) and 112 ferules (40.3%). The male to female ratio was nearly 3:2. Age of the patients: the youngest was 8 months, the oldest was 72 years, most of the cases were in the 21—50 age group, a total of 187 cases (67.3%). Most of them were farmers (87—31.3%), next were workers (79—28.4%). This disease involved most frequently the adolescents and labourers in their prime of life. The right eyes were invoved in 113 patients (40.6%), left eyes 92 (33.1%); binocular involvement occurred in 73 cases (26.3%) while monocular cases were more often seen (73.7%).CLINICAL COURSE: The shortest duration after the onset was 1 day,longest 30 years. Mostly were in6 months (a total of 260 eyes 74.1%).TYPES: Endogenous uveitis can be divided into acute and chronic types which were further divided into anterior, posterior and pan-uveiris. Among 278 cases (351 eyes) there were 147 cases (175 eyes) of acut uveitis and 131 cases (176 eyes) of chronic uveitis, most of which were pan-uveitis.RECURRENCE: The recurrence rate was 31%, of which the ante rior chronic type 38.5% and the pan-uveitis 30.3% were most often seen. EFFECTIVENESS OF THERAFY AND THE VISION BEFORE AND AFTER THE THERA PY: Of the 236 cases (300 eyes) with more detailed records there were 92 eyes (60.5%) of clinical cure in acute uveitis, with a total effective rate of 90.1%, total non-effective rate 9.9%; chronic uveitis of 148 eyes showed clinical cure in 37 eyes (25 %); the total effective rate being68.9% and the total non-effective rate 31.1%. The overall therapeutic effect of acute cases we re better than in chronic cases. In acute cases of uveitis, blindness ( a vision under 0.05) accounted for 41.4% before treatment and reduced to 11.8% after tre-atment. Nevertheless, the percentage of blindness of chronic uveitiswas 39.2% prior to therapy and reduced only to 33.1% thereafter. From the changes in the degree of vision before and after, the effectiveness of treatment is far better in acute cases than in chronic.OCULAR COMPLICATIONS AND SYNDROMES: Among 278 cases, the most frequent ocular complication was cataract, and secondary glaucoma next. Syndromes occurred in 22 cases (12% of 42 eyes): among them were 17 cases (33 eyes) of Harada Vogt-Koyanagi’s syndrome, 3 cases (6eyes) of Behcet’s syndrome, one case (2 eyes) of uveoparotitis, one case (1 eye) of Fuchs’ syndrome and 5 cases (8 eyes) of sympathetic ophthalmia.SYSTEMIC COMPLICATIONS: There were 75.5% cases of unknown etiology in all of the cases; others were systemic diseases related to immunological reactions (16.2%), focal infection (3.6%), pulmonary tuberculosis(2.2%), infectious diseases (about 1.8%) and others (0.7%).PERIOD OF OBSERVATION: Of the patients, 90.6% were followed up for half a year, and only 6.8% for more than 1 year.About the immunological mechanism of endogenous uveitis, it waits for further study.更多还原