强直性脊柱炎伴发葡萄膜炎18例临床分析
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Clinical analysis of ankylosing spondylitis associated with uveitis in 18 cases
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    摘要:

    目的:探讨强直性脊柱炎(ankylosing spondylitis,AS)伴发葡萄膜炎的临床特征、诊断、治疗及预后。

    方法:对2006-06/2012-06在我院就诊的18例18眼葡萄膜炎患者的临床表现、实验室检查以及临床诊疗情况进行系统回顾分析。

    结果:AS伴发葡萄膜炎患者18例,男16例,女2例。AS发病年龄为33±11岁; 葡萄膜炎发病年龄29±13岁。其中13例患者先确诊为AS后就诊于眼科,5例患者以葡萄膜炎首诊于眼科后确诊为AS。18例患者葡萄膜炎持续时间为15~46(平均27±7)d,其中13例有明确葡萄膜炎复发病史。所有患者X线影像学检查均显示骶髂关节炎,其中13例(72%)HLA-B27检查阳性,12例(66.6%)血沉升高,7例(38.8%)C反应蛋白>10mg/L。经过糖皮质激素和睫状肌麻痹剂滴眼液治疗后18例患者前部葡萄膜炎均治愈。

    结论:AS伴发葡萄膜炎多累及中青年男性,多单眼发病,易复发; 根据典型的临床特征及影像学检查结果可明确诊断; 及时有效的治疗均能取得良好效果。

    Abstract:

    AIM: To investigate the clinical characteristics, diagnosis, treatment and prognosis of ankylosing spondylitis(AS)associated with uveitis.

    METHODS: The retrospective analysis of clinical manifestation, laboratory examination and clinical diagnosis and treatment on 18 patients with uveitis(18 eyes)from June 2006 to June 2012 in our hospital.

    RESULTS: A total of 18 patients with AS associated with uveitis, including sixteen males and two females were included. Onset age of AS patients was(33±11)years old, while uveitis patient was(29±13)years old. Thirteen patients were diagnosed as AS first and then went to ophthalmology department; other five patients were diagnosed as uveitis first but later as AS. Uveitis duration of 18 patients was 15-46(27±7)days and thirteen patients among them had clear recurrent history. All patients showed typical sacroiliitis in X-ray imaging examination; thirteen patients(72.2%)had positive HLA-B27; twelve patients'(66.6%)erythrocyte sedimentation rate were increased; Seven patients'(38.8%)CRP were>10mg/L. Anterior uveitis of all patients cured after systemic treatment with corticosteroids and cycloplegic eye drops.

    CONCLUSION: AS associated with uveitis is usually presented in young males,which is often characterized by unilateral onset and recurrent relapse. Based on typical clinical features and radiographic results, the diagnosis can be made. Early and effective treatment can achieve good effects.

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陈丽华,伍雪芬,许福荣,等.强直性脊柱炎伴发葡萄膜炎18例临床分析.国际眼科杂志, 2014,14(1):160-161.

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  • 收稿日期:2013-09-06
  • 最后修改日期:2013-12-06
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  • 在线发布日期: 2013-12-23
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