摘要
目的 :探讨多发性硬化 (MS)患者的临床表现、相关检查、眼部发病特点以及疗效分析。方法 :收集 195 0年～ 2 0 0 1年期间的多发性硬化住院患者 188例。所有患者均符合Poser诊断标准。分析其全身及眼部发病特点 ,相关检查及治疗效果。结果 :男女患者性别构成比例为 1∶2 8。患者首发年龄 ,最小者为 4岁 ,最大为 70岁 ,多见于 2 0～ 45岁 ,分别在 2 0岁和 3 5岁左右呈现两个MS首发的高峰。眼部首发表现 :以眼部为首发表现者占 3 0 3 % ( 5 7/188)。眼部与其它部位同时发病者占 18 1%( 3 4/188) ;非眼部首发者占 5 0 5 % ( 95 /188)。将患者按年龄划分为三组。在各年龄组之间 ,其首发差别无显著的统计学意义。在各年龄组中 ,眼部首发眼数与性别均无明显相关性。 90 4%患者其眼部发病与全身发病的相互间隔时间在 3年以内。在眼部受累的患者中 ,双眼受累者占 91 9% ( 12 4/13 5 )。 95 %的患者在 3年内双眼先后受累。眼部检查异常最常见者为 :视野异常占受检者的 93 5 % ;视力显著减退占受检者的 82 9% ;视诱发电位 (VEP)异常者占 81 7% ;眼肌麻痹者占受检者的 41 9% ,其中 5 2 %呈现一过性病程。视野改变呈现多种形态的视野缺失。常见为中心及旁中心暗点。眼部受累患者VEP检查的阳性率为87 6% ( 85
Objective:To investigate Multiple Sclerosis(MS) with clinic manifestation,correlated examination,ocular behavior and medical effect. Methods:Collection of 188 MS in-patient cases which were admitted from year 1950 to year 2001.Those systemic and ocular symptoms,correlated examinations and therapy were analyzed. Results:The ratio of male to female was 1∶2.8.First attack aged from 4～70,mostly within 20～45 years.Their age concentrated at two peaks located at 20 and 35 year.30.3%(57/188) of the MS patients initially broke out as ocular manifestation.18.1%(34/188) of the MS cases broke out as systemic and ocular symptoms simultaneously.50.5%(95/188) of cases initiated elsewhere.MS patients were divided into three groups by their age,and no significant difference was observed among each group by age.The number of initial affected eye and gender appeared no relationship.The interval of systemic and ocular symptom was within three years in 90.4% of patients.91.9%(124/135) of the patients involved in eyes were affected with both eyes simultaneously.And,both eyes were affected in succession in 95% of cases.Among the abnormal results of eye exams,visual fields abnormality accounted for 93.5%;distinct visual deterioration accounted for 82.9%;81.7% of the available cases showed abnormal VEP results.Ophthalmoplegia accounted for 41.9% of the available cases,and 52% of them were transient.The form of visual field abnormality was diverse and central and Para central scotoma was most often seen.Positive rate of VEP exam of cases with eye affected was 87.6%(85/97).Seven of them appeared no symptom,but still got abnormal VEP result.81%(30/37)of cases with positive VEP result did not recover when they were rechecked during remission.MRI,CSFIgG and OB were somewhat abnormal too,in MS cases.Glucose cortical steroids were the first choice of most MS patients.82%(50/61)of those cases whose eyes were affected could Remit spontaneously or through treatment.within 1 year,ophthalmopathy recur or the other eye affect was observed in
出处
《中国实用眼科杂志》
CSCD
北大核心
2003年第10期750-754,共5页
Chinese Journal of Practical Ophthalmology
