常规抗结核药物对视觉光敏感度的影响

The Effect of General Anti-tubercle Medicine on Visual Light Sensitivity of the Tubercular Patients

【目的】通过全自动静态视野计对结核病患者服用抗结核药物前后的平均光敏感度(MS)检查结果做比较分析,以期了解除乙胺丁醇外,常规抗结核药物对视功能的影响。【方法】随机选择既往无眼病史的初发结核病患者,在其药物治疗前以及服药后1个月分别进行全自动静态视野检查;随机选择健康人做对照组,间隔1个月分别进行全自动静态视野检查。将检查结果经统计学处理并作分析。【结果】46例病人共92眼中,用药后MS比较差异有显著性的为40眼;对照组31人共62眼中,2次视野检查MS 10眼比较差异有显著性(P<0.01)。在平均缺损(MD)方面,病人组用药前后有38例比较差异有显著性,对照组2次检查8例比较差异有显著性(P<0.01)。【结论】结核病人在服用抗结核药物一个月后,视觉MS下降的人数显著多于对照组,说明服用抗结核药物的病人MS和MD下降是药物作用所至;也就是说:除乙胺丁醇外,常规的抗结核药物对视觉敏感度仍有损害,这应该在防盲治盲方面引起临床工作者的重视。建议接受抗结核治疗的患者在服药期间应监控其视功能的变化。

[Objective]To study effect of general anti-tubercle medicine on visual function of the tubercular patients besides ethambutol, by analysing visual light sensitivity with automated static perimetry. [Methods] The visual function of the preliminary tubercular patients was detected with automated static perimetry before taking anti-tubercle medicine and after one month. The health people were used for control group. [Results] The visual fields of 92 eyes on 46 tubercular patients were detected with automated static perimetry. The mean sensitivity（MS） of 40 eyes after taking anti-tubercle medicine besides ethambutol was significantly decreased than before. There were 62 eyes of 31 health people in control group. The MS of 10 eyes was significantly decreased. The X^2 value between patient group and the control group was 24.72（ P 〈0.01）. The mean defect （MD） of 38 eyes after taking anti-tubercle medicine was significantly decreased than before. The MD of 8 eyes on health people was significantly decreased. The 7,2 value between patient group and the control group about MD was 22.37（ P 〈0.01）. [Conclusion]The general anti-tubercle medicine could damage visual light sensitivity of patients. This result should bring clinical doctor＇s attention on influence of general anti-tubercle medicine. The visual light sensitivity should be detected in tubercular patient duringtreatment.