摘要
目的观察自身免疫性视神经病的临床特点。方法回顾分析2006年1月至2007年12月我院自身免疫性视神经病住院患者58例的临床资料。通过眼科和神经内科常规检查，视野、自身免疫抗体、头颅MRI等检查，对入组患者视力损害特点、视神经外临床和临床下受累情况等进行分析总结。结果58例患者共93只眼受累，住院期间最差的最佳矫正视力（BCVA）在0.1以下者68只眼，占73.1%；伴有神经系统其他表现者10例，占17.2%；伴有神经系统外其他临床症状者14例，占24.1%。实验室检查结果显示ANA阳性者43例，占79.6%；其他异常抗体包括：抗干燥综合症抗原A或抗原B抗体、抗双链DNA抗体、抗组蛋白抗体、抗心磷脂抗体和HLA-B27。诊断符合系统性结缔组织病者20例，占34.5% ，其中以干燥综合征、系统性红斑狼疮和白塞病较为常见。伴有头颅MRI异常者32例，占55.2% 。住院治疗后BCVA明显好转者49只眼，占77.7%。结论自身免疫性视神经病视功能受累多较重。部分患者伴有其他系统以及神经系统其他部位损害的表现。部分为系统性结缔组织病累及视神经，其余多数表现为孤立性自身免疫性视神经病。
ObjectiveTo observe the clinical features of autoimmune optic neuropathy （AON）. MethodsThe clinical data of 58 patients with AON from Jan. 2006 to Dec. 2007 were retrospectively analyzed. The patients had undergone routine ophthalmological, neurological examination, visual field test, all set of autoimmune antibody test, brain MRI. ResultsIn 93 eyes of 58 patients with AON, the lowest best corrected visual acuity （BCVA） was 〈0.1 in 68 eyes （73.1%）, 10 patients （17.2%） had other symptoms of nervous system, 14 patients （24.1%） had lesions of nonneurological system. Positive antinuclear antibody was found in 43 patients （79.6%）; other abnormal antibodies were also found, including antiSSA/SSB, antidsDNA, antihistonic, anticardiolipin, and antihuman leukocyte antigen B27 antibodies. Systematic connective tissue disease presented in 20 patients （34.5%）, such as sicca syndrome, systemic lupus erythematosus, and Behcet disease. 32 patients （552%） had abnormal brain MRI, and the BCVA of 49 eyes （77.7%） improved significantly after hospitalization. Conclusion Patients with AON always have poor visual function, some of whom associate with other systems, as well as damages to other parts of the nervous system. While some AON patients are secondary to systemic connective tissue disease involving the optic nerve, the majority of these patients are isolated autoimmune optic neuropathy.
出处
《中华眼底病杂志》
CAS
CSCD
北大核心
2009年第6期447-450,共4页
Chinese Journal of Ocular Fundus Diseases
关键词
神经系统自身免疫疾病/诊断
神经系统自身免疫疾病/药物疗法
Autoimmune diseases of the nervous system/diagnosis
Autoimmune diseases of the nervous system/drug therapy
