选择性应用环孢霉素A联合激素治疗Vogt—小柳-原田综合征研究

A clinical study on glucocorticosteroid combined with cyclosporin A in the treatment of Vogt- Koyanagi- Harada syndrome

目的探讨对Vogt-小柳-原田综合征（VKHs）患者有效且安全地治疗方案。方法对2006年12月至2009年1月在中山大学附属眼科中心连续住院和门诊治疗的108例VKHs患者的病情初发或复发、治疗前后视力、用药、疗程长短等情况进行回顾性分析，将初诊和转诊患者的视力预后及复发情况进行对比。结果环孢霉素A在108例病例中的总使用率为49．07％，在初发和复发病例中的使用率分别为38．27％，81．48％；初诊病例的视力恢复好于转诊病例差异有统计学意义（P〈0．05）；初诊病例的复发率低于转诊病例差异有统计学意义（P〈0．05）。结论早期使用大剂量糖皮质激素＋根据个体选择性应用环孢素A的联合用药方案，对VKHs患者的治疗效果理想，复发率低，药物全身毒副反应发生率低。

Objective To evaluate the efficacy and security of the therapeutic scheme to the pa- tients of Vogt- Koyanagi- Harada syndrome. Methods A retrospective analysis was given to 108 pa- tients with Vogt-Koyanagi-Harada syndrome dated from Dec. 2006 to Jan. 2009 on the recurrence, medication, visual prognosis and course of treatment. The visual prognosis and recurrence of the first-visit cases and the transfer-visit cases were compared. Results Cyclosporin A was applied in 49.07% of patients. 38.27% and 81.48% in the first attack and the recurrent patients respectively; the visual prognosis 〉~1.0 of ~：the first-visit cases was better than the transfer-visit cases （P 〈0.05）; the recurrence rate of the first-visit cases （5.41%） was lower than the transfer-visit cases （17.65%） （P 〈0.05）. Conclusions Glucocorticosteroid combined with Cyclosporin A applied in this study im- prove the treatment results with lower recurrence and systemic side effects.