葡萄膜炎复发原因调查

Survey on the Causes of Uveitis Recurrence

目的调查分析诱导葡萄膜炎患者炎症复发的相关因素,为更好的疾病防治提供依据。方法从2011年7月至9月间就诊于北京协和医院眼科葡萄膜炎专科门诊的葡萄膜炎患者中筛选符合葡萄膜炎复发条件的患者99例,填写复发原因调查表,内容包括复发前2周内用药、全身疾病、工作学习强度、精神状况、饮食等情况。结果 99例葡萄膜炎复发患者中,92.9%可找到诱发原因,70.7%的复发与同时存在2个及以上诱发因素相关。复发与糖皮质激素或免疫抑制剂减停或更换相关者占53.5%,尤其在Behcet病患者中占71.9%,在Vogt-小柳-原田病患者中占77.8%;与劳累相关者占37.4%;与生物钟紊乱相关者占24.2%;与全身疾病诱发相关者占22.2%;与情绪波动相关者占22.2%;其他诱因还包括便秘(12.1%)、气候和地域变化(8.1%)、饮食不适(7.1%)、烟酒过度(6.1%)。7.1%的复发患者无可查原因。结论在葡萄膜炎治疗过程中,用药减停或更换、疲乏劳累、生物钟紊乱、其他疾病诱发、情绪波动等均是诱导复发的主要因素。

Objective To analyze the causes of uveitis recurrence with an attempt to improve uveitis management. Methods Totally 99 patients with uveitis recurrence from July 2011 to September 2011 in uveitis clinic of Peking Union Medical College Hospital received a questionnaire-based survey on the potential causes of the relapses. Results Among these 99 patients with uveitis recurrence, the causes of relapses were found in 92 patients （92.9%）, and 70. 7% patients had two or more causes. And the relapse was associated with the withdrawal or switching of glucocorticoids or immunosuppressive agents in 53.5% patients, particularly among those with Behcet＇s disease （71.9%） or Vogt-Koyanagi-Harada syndrome （77.8%）. The recurrence was also found to be related with fatigue （37.4%）, biological clock disorder （24.2%）, systemic diseases （22. 2% ）, and mood swings （22. 2% ）, Other factors included constipation （12. 1% ）, climate and geographical changes （8.1%）, improper diets （7. 1% ）, and excessive alcohol and tobacco use （6. 1% ）. The cause was unclear in 7 patients （7. 1% ）. Conclusions During the treatment of uveitis, inappropriate medication, fatigue, biological clock disorder, other diseases, and mood swings may trigger its recurrence.