强直性脊椎炎伴发葡萄膜炎的治疗分析

Clinical treatment of uveitis associated with ankylosing spondylitis

目的探讨糖皮质激素联合免疫抑制剂治疗强直性脊椎炎（AS）伴发葡萄膜炎的临床效果。方法对郑州大学第四附属医院眼科在2009年1月至2011年6月确诊为AS伴发葡萄膜炎的35例（58只眼），严重患者根据病情程度给予糖皮质激素联合甲氨喋呤（MTX）、环孢素A进行系统治疗，定期随访12，29个月，对治疗前后的视力、用药剂量和长短、毒副作用等情况进行回顾性分析。结果所有患者经糖皮质激素联合免疫抑制剂治疗≥1年，46只眼（79．3％）的视力显著提高。33例（94-3％）患者的葡萄膜炎得到完全控制。治疗6个月，所有患者晨僵时间、关节疼痛数、胸廓活动度均明显改善。结论AS伴发葡萄膜炎的严重患者给予糖皮质激素联合MTX、环孢素A进行系统化治疗，效果理想，毒副作用小，是安全有效的治疗方案。

Objective To evaluate the therapeutic effect of corticosteroids and immunosuppres- sive in uveitis associated with ankylosing spondylitis （AS）. Methods Thirty-five serious patients （58eyes） diagnosed with uveitis associated with AS were collected in our hospital from January 2009 to June 2011. According to the severity of disease, all patients were treated with corticosteroids com- bined with methotrexate （MTX） and cyclosporin A systematically and followed up from 12 to 29 months. Visual acuity, dose and side effects of drugs were reviewed. Results According to treat- ment of corticosteroids and immunosuppressive for more than one year, visual acuity of 46 eyes was improved significantly; uveitis of 33 patients （94.3%） were controlled completely. All patients with duration of morning stiffness, arthralgia, and thoracic activity improved significantly. Conclu- sions The systemic treatment with corticosteroids combined with MTX and cyclosporine A is safe and effective for the serious patients of uveitis associated with AS and the toxic side effects is small.