【摘要】 【目的】探讨多发性硬化(MS)患者眼部发病的临床特征、诊治和病情转归。【方法】收集1998年1月至2007年12月期间我院多发性硬化住院患者72例,所有患者均符合Poser诊断标准,回顾性分析其全身和眼部发病特征及治疗情况,并随访追踪病情转归。【结果】多发性硬化多见20～50岁女性患者,25.4%(18/72)以眼部为首发症状,其中83.3%(15/18)表现视神经炎;12.5%(9/72)眼部和其他部位同时发病;尚有22.2%(16/72)在患病过程中出现视神经炎。视神经炎临床表现呈复发-缓解型,多次复发预后差。首次患病缓解后两年内75%～88%患者累及其他部位。首次患病核磁共振(MRI)联合视觉诱发电位(VEP)、脑干听觉诱发电位(BAEP)和体感诱发电位(SSEP)等检查,可提高MS的诊断率。急性期大剂量激素冲击治疗,或联合免疫球蛋白、免疫抑制剂,缓解期使用干扰素治疗能有效控制病情,减少复发,降低致盲率。【结论】MS患者眼部是常见受累器官之一,并常见首发眼部受累,多表现视神经炎。视神经炎临床表现呈复发-缓解型。首次患病行MRI联合VEP、BAEP、SSEP等检查,可提高MS的诊断率。联合使用激素、免疫球蛋白、免疫抑制剂、干扰素等能有效控制病情,减少复发率,降低致盲率。更多还原

【Abstract】 [Objective]To investigate multiple sclerosis(MS) with ocular manifestation,medical effect and results. [Methods]Collection of MS in-patient cases which were admitted from January 1998 to January 2007.Those systemic and ocular symptoms and therapy were analyzed retrospectively.[Results]MS was commonly seen in females aged from 20-50 years. 25.4%(18/72) of the MS patients initially broke out as ocular manifestation,and among them 83.3%(15/18) signed optic neuritis (ON).12.5%(9/72) of the MS cases broke out as systemic and ocular symptoms simultaneously.22.2%(16/72) signed ON after the first attack.ON is characterized by recurrent relapses and followed by progressive deterioration and cognitive disability.75%- 88%MS cases broke out elsewhere after the first attack’s relapse.The combination examinations of Magnetic resonance imaging (MRI),VEP,BAEP and SSEP improved the diagnosis.Methylprednislone recombinant with interferon is beneficial in relapsing-remitting MS by reducing the frequency of relapses,slowing down the progression of physical disability.[Conclusion]MS is commonly initially broke out as ocular manifestation and signed ON.ON is characterized by recurrent relapses.The combination examinations of MRI,VEP,BAEP,and SSEP improved the diagnosis.Methylprednislone recombinant with interferon is beneficial in relapsing-remitting MS by reducing the frequency of relapses,slowing down the progression of physical disability.更多还原