中国和印度原发性先天性青光眼患者临床特点的对比研究(英文)

A comparison study of the clinical features between Chinese and Indian primary congenital glaucoma patients

目的:总结中国原发性先天性青光眼患者的临床特点,与印度原发性先天性青光眼患者进行比较,研究二者临床特点的差异。方法:对中国和印度的原发性先天性青光眼患者进行回顾性分析。复习40例中国先天性青光眼患者的病历记录,将临床特点总结为几个可定量临床参数,评价疾病的严重程度。将中国患者的量化临床特点以及病情严重度分级和文献中的印度患者比较,进行统计分析。结果:中国患者40例和印度患者43例纳入了研究。中国患者的性别比例约为2∶1,3例(7.5%)患者有家族史,1例(2.5%)患者的亲代为近亲婚配。中国患者的主要症状和体征较多,初诊时最常见的症状是眼球长大(42.5%)、视力下降(35.0%)。与印度患者比较,中国先天性青光眼患者发病较晚,诊断较迟,角膜增大和视神经损害更严重(P<0.01)。两国的眼科医生都倾向于采用小梁切开联合小梁切除术。印度患者接受联合手术的比例更高(P<0.01)。两国患者的病情严重程度分布不同,大部分中国患者的病情严重,而大部分印度患者的病情非常严重(P<0.01)。结论:中国原发性先天性青光眼患者为散发病例,非近亲婚配型。与印度原发性先天性青光眼患者比较,中国患者的发病较晚,诊断治疗相对滞后。中国先天性青光眼的防治工作尚待加强。

AIM： To summarize the clinical features of Chinese primary congenital glaucoma and to investigate the discrepancies of the clinical features between the Chinese and Indian patients. METHODS： Clinical records of 40 Chinese primary congenital glaucoma patients were reviewed. The clinical features were summarized as several quantifiable clinical parameters and the severity of the disease was evaluated. Both the quantified clinical features and severity were statistically compared with those of the Indian patients, which were cited from the previous published articles. RESULTS： 40 Chinese and 43 Indian patients were included in the study. In Chinese patients, sex ratio （male to female ）was about 2：1, family history was presented in 3 patients（7.5% ） and consanguinity was found in one patient （2.5%）. The main symptoms and signs observed in Chinese patients spanned a wide spectrum of manifestations. The most frequent signs noted on the initial examination were enlarged eyeball （42.5%） and decreased visual acuity （35.0%）. Compared with Indian patients, Chinese patients had a later onset, a delayed diagnosis, more severe corneal changes and more severe optic nerve damages （P〈0.01）. The combined tabeculectomy and trabeculotomy operation was preferred by both Chinese and Indian doctors whereas a higher proportion of Indian patients received the combined operation （P〈0.01）. The proportions of the severity grade were different between Chinese and Indian patients. Most Chinese patients were in the severe grade while most Indian patients were in the very severe grade （P〈0.01）. CONCLUSION： Chinese primary congenital glaucoma patients were sporadic and non-consanguineous. Compared with Indian patients, Chinese patients had a relative later onset, a delayed diagnosis and treatment. More attempts are needed in Chinese PCG prevention and treatment.