大剂量甲泼尼龙冲击治疗vogt―小柳―原田病的效果观察

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1、大剂量甲泼尼龙冲击治疗Vogt—小柳一原田病的效果观察水肿消退，OCT示浆液性视网膜脱离消失，FFA荧光素渗漏减轻。视力提高缓慢的32眼发病时间均^2周，用药2周视力方缓慢提高。3眼治疗无效后改免疫抑制剂治疗。BCVA转换为logMAR视力分析显示：与治疗前相比，治疗3d及7d后患眼视力明显改善，差异有高度统计学意义；与治疗3d后相比，治疗7d后视力亦明显提高，差异有高度统计学意义。OCT变化情况分析显示：与治疗前相比，治疗3d及7d后平均黄斑中心凹区ILM-RPE视网膜厚度、黄斑部视网膜容积以及黄斑部视网膜平均容积厚度均明显下降，差异有高度

2、统计学意义；与治疗3d后相比，治疗7d后平均黄斑中心凹区ILM-RPE视网膜厚度、黄斑部视网膜容积以及黄斑部视网膜平均容积厚度均明显下降，差异有高度统计学意义。所有患者随访1年，未见严重不良反应，其中3例患者于治疗后半年内复发，再次予以冲击治疗，随访稳定。结论大剂量甲泼尼龙冲击治疗Vogt-小柳-原田病疗效确切、视功能恢复快、复发率低、不良反应少，是一种安全有效的治疗方法。且发病时间越短，治疗效果越好。［关键词］Vogt-小柳-原田病；甲泼尼龙；糖皮质激素1673-721006-0134-04[Abstract]ObjectiveToobse

3、rvetheeffectofhigh-doseMethylprednisolonetreatmentonVogt-Koyanagi-Haradadisease.MethodsSixty-ninehospitalizedpatientsdiagnosedwithVogt-Koyanagi-HaradadiseasefromJanuary2013toJanuary2016inXuhuiDistrictCentralHospitalofShanghaiwereanalyzedretrospectively.Allpatientsreceivedhi

4、gh-doseMethylprednisolonetreatment，withMethylprednisolone1.0g/dinearlymorningsforthreeconsecutivedays，andthenthedosagewastaperedbasedontheconditionimprovement.Beforeandafterbeingtreatedforthreeandsevendays，allpatientsunderwentvisionacuityexamination，fundusexamination,optica

5、lcoherencetomographyandfundusfluoresceinangiography.Thechangeswereanalyzed，andthepatientswerefollowedupforoneyear.ResultsAftertreatmentforoneweek，therewere100eyeswhosevisionacuitywereimprovedsignificantly[bestcorrectedvisionacuity>0.6],retinaedemasubsided，retinaldetachmentd

6、isappearedinOCTandfluorescenceleakagereducedinFFA.Allofthe32eyeswithvisionacuityslowlyimprovedweretreatedafteranonsetofnolessthantwoweeks.TheBCVAwasimprovedslowlyaftertreatmentfortwoweeks.Therewere3eyesthatshowednoresponsetothehigh-dosemethylprednisolonetreatmentandthenrece

7、ivedimmunosuppressanttherapy.AnalysisoflogMARvisionconvertedfromBCVA，visionacuityofallpatientswasimprovedobviouslyaftertreatmentforthreedaysandsevendayscomparedtobeforetreatment，withstatisticallysignificantdifferences；moreover,visionacuityofallpatientswasimprovedmarkedlyaft

8、ertreatmentforsevendayscomparedtothataftertreatmentforthreedays，andthedifferencewa