眼B超在中西医结合治疗Vogt-小柳-原田病中的应用

Combination of traditional Chinese and western medicine for treatment of Vogt-Koyanagi-Harada disease using the B-ultrasonography

目的观察Vogt-小柳-原田病(Vogt-Koyanagi-Harada disease,VKH)中西医结合治疗方法的效果,探讨眼B超检查对VKH的价值。方法均详细询问记录患者病史,做裂隙灯显微镜、散瞳查眼底及三面镜、光学相干断层扫描(OCT)、眼B超、眼底荧光血管造影(FFA)、吲哚青绿眼底血管造影(ICGA)等检查。治疗过程分为炎症期和恢复期治疗。结果所有患者经过系统治疗后炎症得到控制。①所有患眼治疗后视力明显提高。②所有患者有明显的疗效。③治疗前B超检查73%眼玻璃体内见大量细小弱回声点,94%眼可见视网膜脱离光带,呈扁平状,隆起度不高,眼球壁不光滑,100%眼可见脉络膜增厚。治疗后玻璃体混浊、视网膜脱离和脉络膜增厚好转至正常。视力提高与B超结果有好的一致性。结论①中西医结合是治疗VKH有效的方法。②B超是有用的诊断方法之一,为病情追踪、疗效评价和指导用药提供依据。

OBJECTIVE To evaluate the effectiveness of combination of traditional Chinese and westem medicine for treatment of Vogt - Koyanagi - Harada disease. To investigate the clinical value of objective optical B-mode ultrasonography.METHODS A total of 26 patients （52 eyes） with Vogt - Koyanagi - Harada disease （VKH） were diagnosed by fundus fluorescein angiography （FFA） and indocyanine green angiography （ICGA）, optical coherence tomography （OCT）, B-uhrasonography, divided into uveitis stage and chronic stage. Before and after the treatment, they were examined by B-ultrasonography. RESULTS The uveitis was controlled in all the patients （52 eyes） .The original cases eyes at the third month were recovery in traditional and western combination group 52/52 （ 100% ） . At the third week and the third month, vision sight were 0.4 or more in traditional and western combination group 46/52 （89%）, 51/52 （98 % ） . Before the treatment, B-ultrasonography feature were 73 % vitreous body was opacities, 94% retinal detachment, 100% choroids thickness. After the treatment, B-ultrasonography feature straighten gradually, normal. CONCLUSIONS Traditional and western combination method of therapy were effective. Patienel of traditional and western combination group treatment were recovery faster, uveitis disappeared more quickly. B- ultrasonography are useful method for the diagnosis of VKH and they are able to pursue state of illness, appraise curative effect, coach using medicine, too.