1155例葡萄膜炎的临床分析

Clinical Analysis of 1155 Patients with Uveitis

目的探讨浙江省眼科医院葡萄膜炎的病因及临床类型。方法回顾性分析2006年12月～2012年5月就诊于笔者医院葡萄膜炎专科的患者临床资料,按病因和解剖位置分类,研究其发病年龄、性别、受累眼别和临床类型等。结果各型葡萄膜炎患者共计1155例。其中男性654例,女性501例,患者平均发病年龄37.7±14.7岁,单双眼受累之比为1∶1.04。按解剖位置分类,前葡萄膜炎636例,全葡萄膜炎349例,后葡萄膜炎125例,中间葡萄膜炎45例,分别占55.1%、30.2%、10.8%和3.9%。能确定病因或归于特定类型的共769例,占66.6%,常见病因或类型为Vogt-小柳原田综合征(VKH综合征,220例,19.1%)、病毒性葡萄膜炎(143例,12.4%)、不伴有强直性脊椎炎的HLA-B27相关性前葡萄膜炎(121例,10.5%)、强直性脊椎炎(91例,7.9%)、Fuchs综合征(50例,4.3%)和Behcet病(49例,4.2%);其余386例为特发性葡萄膜炎,占33.4%,且以特发性前葡萄膜炎最常见(占全部特发性病例的56.2%)。结论葡萄膜炎常侵袭青壮年,男性患者略多于女性;可单眼或双眼同时发病;其常见病因或类型为特发性葡萄膜炎、VKH综合征、病毒性葡萄膜炎、HLA-B27相关性前葡萄膜炎、强直性脊椎炎、Fuchs综合征和Behcet病等。

Objective To investigate and analyze the prevalence of uveitis and to explore the etiology and clinical classification of uveitis. Methods We retrospectively analyzed 1155 patients with uveitis referred to Zhejiang Eye Hospital during the period of December 2006 to May 2012. All patients with uveitis were classified into certain groups according to the anatomical and etiological criteria. In addi- tion, other relevant data such as age of onset, sex and eye of involvement were also analyzed. Results The average age at disease onset （654 males and 501 females） was 37.7±14.7 years. 1747 eyes in 1155 patients were included and 592 patients （51.3%） were bilateral eases. The most common type was anterior nveitis （636 cases, 55. 1% ）, followed in descending order by pan uveitis （349 cases, 30.2% ） , posterior uveitis （ 125 cases, 10.8% ） and intermediate uveitis （45 cases,3.9% ）. 769 cases （accounting for 66.6% of all the patients） could be identified etiological factors or clinical entities. Vogt - Koyanagi - Harada syndrome （VKH ,220 cases, 19.1% ） ,virus infection （ 143 cases, 12.4% ） , HLA - B27 associated anterior uveitis （ 121 cases, 10.5 % ） , ankylosing spondylitis （ 91 cases, 7.9% ）, Fuchs syndrome （50 eases,4.3% ） and Behcet disease （49 cases,4.2% ） were the most common types seen in our study. And the other 386 cases （33.4%） were idiopathic ones which could not find out etiological factors. The idiopathic anterior uveitis was the most common type （217 cases） , accounting for 56.2% of all patients with idiopathic uveitis. Conclusion In our study, uveitis was a disease with variable etiologies and usually occurred in young and middle - aged adults. It could be bilateral or unilateral in the development of uveitis. Totally speaking,the incidence of uveitis in males was slightly higher than in females. Vogt - Koyanagi - Harada syndrome, virus infection, HLA - B27 associated anterior uveitis,ankylosing spondylitis,Fuchs syndrome and Behcet disease were the most common types of uveitis.