本文選題：Vogt-小柳-原田綜合征 + 葡萄膜炎��； 參考：《石河子大學(xué)》2013年碩士論文

【摘要】：目的探討Vogt-小柳-原田綜合征（Vogt-Koyanagi-Harada sydrome，VKH）臨床特點，診斷，治療及治療效果。 方法收集2001年1月-2011年12月在我院就診的20例39眼VKH患者的臨床資料，對其眼部表現(xiàn)、全身癥狀、眼底熒光素血管造影（fundus fluorescein angiograghy，F(xiàn)FA），光學(xué)相干斷層成像術(shù)（opticalcoherence tomography，OCT),超聲生物顯微鏡（ultrasound biomicroscope UBM)和治療方法，治療結(jié)果和并發(fā)癥的治療進(jìn)行回顧性分析。所有患者給予大劑量糖皮質(zhì)激素治療。 結(jié)果該組病例中20例（39眼）均為初發(fā)患者，19例雙眼發(fā)病，1例單眼發(fā)病。20例患者誤診為青光眼2例，急性視網(wǎng)膜色素上皮炎2例，視神經(jīng)視網(wǎng)膜炎2例，中心性漿液性脈絡(luò)膜視網(wǎng)膜病變1例。發(fā)病前有前驅(qū)癥狀者14例（70%），主要為頭痛，惡心，嘔吐。就診時有眼外癥狀和體征者16例（80%），包括中樞神經(jīng)系統(tǒng)異常、聽力障礙、脫發(fā)和白癜風(fēng)。FFA檢查表現(xiàn)為斑駁狀高熒光、視盤色染和多湖樣熒光積存。所有患者給予大劑量糖皮質(zhì)激素治療，一周后20例患者的視力均有不同程度的改善。隨訪6個月，3例患者復(fù)發(fā)。 結(jié)論前驅(qū)癥狀，臨床病程，眼外表現(xiàn)及FFA等有助于Vogt-小柳-原田綜合征的診斷，早期給予大劑量糖皮質(zhì)激素治療，絕大部分患者可控制炎癥，，改善視力；但有復(fù)發(fā)傾向，嚴(yán)密觀察，應(yīng)長期隨訪。
[Abstract]:Objective to investigate the clinical features, diagnosis, treatment and therapeutic effect of Vogt-Koyanagi-Harada sydrome-VKH syndrome. Methods from January 2001 to December 2011, the clinical data of 39 eyes of 20 patients with VKH in our hospital from January 2001 to December 2011 were collected. Fundus fluorescein angiograghy FFAA, optical coherence tomography (Oct), ultrasound biomicroscopy (ultrasound biomicroscope), treatment methods, treatment results and complications were analyzed retrospectively. All patients were treated with high dose glucocorticoid. Results all of the 20 cases (39 eyes) were diagnosed as primary patients, 19 cases with binocular disease, 1 case with monocular disease. 20 cases were misdiagnosed as glaucoma, 2 cases were acute retinal pigment dermatitis, 2 cases were optic nerve retinitis, 2 cases were diagnosed as glaucoma, 2 cases were acute retinal pigment dermatitis, and 2 cases were optic neuroretinitis. One case of central serous chorioretinopathy. There were 14 cases with preemptive symptoms before onset, mainly headache, nausea and vomiting. There were 16 patients with extraocular symptoms and signs, including central nervous system abnormalities, hearing impairment, alopecia and vitiligo. FFA examination showed mottled hyperfluorescence, color staining of optic disc and accumulation of multilake fluorescence. All the patients were treated with high dose glucocorticoid, and the visual acuity of 20 patients improved in varying degrees after one week. Three patients with recurrence were followed up for 6 months. Conclusion prodromal symptoms, clinical course, extraocular manifestations and FFA are helpful to the diagnosis of Vogt- Xiaoliu-Harada syndrome, and early treatment with high dose glucocorticoid can control inflammation and improve visual acuity in most patients, but they tend to recur. Close observation should be followed up for a long time.
【學(xué)位授予單位】：石河子大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2013
【分類號】：R773.9

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