协和医学杂志

2013, (02)

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葡萄膜炎复发原因调查
Survey on the Causes of Uveitis Recurrence

杨永升;张美芬;庄曾渊

摘要(Abstract):

目的:调查分析诱导葡萄膜炎患者炎症复发的相关因素,为更好的疾病防治提供依 据。方法:从2011年7月至9月间就诊于北京协和医院眼科葡萄膜炎专科门诊的葡萄膜炎患 者中筛选符合葡萄膜炎复发条件的患者99例,填写复发原因调查表,内容包括复发前2周内 用药、全身疾病、工作学习强度、精神状况、饮食等情况。结果:99例葡萄膜炎复发患者中, 92.9%可找到诱发原因,70.7%的复发与同时存在2个及以上诱发因素相关。复发与糖皮质激 素或免疫抑制剂减停或更换相关者占53.5%,尤其在Behcet病患者中占71.9%,在Vogt-小 柳-原田病患者中占77.8%;与劳累相关者占37.4%;与生物钟紊乱相关者占24.2%;与全身 疾病诱发相关者占22.2%;与情绪波动相关者占22.2%;其他诱因还包括便秘(12.1%)、气候 和地域变化(8.1%)、饮食不适(7.1%)、烟酒过度(6.1%)。7.1%的复发患者无可查原因。结论:在葡萄膜炎治疗过程中,用药减停或更换、疲乏劳累、生物钟紊乱、其他疾病诱发、情 绪波动等均是诱导复发的主要因素。
Objective:To analyze the causes of uveitis recurrence with an attempt to improve uveitis management. Methods:Totally 99 patients with uveitis recurrence from July 2011 to September 2011 in uveitis clinic of Peking Union Medical College Hospital received a questionnaire-based survey on the potential causes of the relapses. Results:Among these 99 patients with uveitis recurrence, the causes of relapses were found in 92 patients (92.9%), and 70.7% patients had two or more causes. And the relapse was associated with the withdrawal or switching of glucocorticoids or immunosuppressive agents in 53.5% patients, particularly among those with Behcet's disease (71.9%) or Vogt-Koyanagi-Harada syndrome (77.8%). The recurrence was also found to be related with fatigue (37.4%), biological clock disorder (24.2%), systemic diseases(22.2%), and mood swings (22.2%). Other factors included constipation (12.1%), climate and geographical changes (8.1%), improper diets (7.1%), and excessive alcohol and tobacco use (6.1%). The cause was unclear in 7 patients (7.1%). Conclusions:During the treatment of uveitis, inappropriate medication, fatigue, biological clock disorder, other diseases, and mood swings may trigger its recurrence.

关键词(KeyWords): |葡萄膜炎|复发|诱发因素|
|uveitis|recurrence|causes|

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作者(Author): 杨永升;张美芬;庄曾渊

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