免疫抑制剂治疗葡萄膜炎

Effectiveness and analysis of immunosuppressants in the treatment of 166 patients with uveitis

目的观察免疫抑制剂治疗葡萄膜炎的安全性和有效性。方法临床确诊为葡萄膜炎的166例（258眼）患者纳入研究，其中前葡萄膜炎78例（46．99％），全葡萄膜炎70例（42．17％），中间葡萄膜炎11例（6．63％），后葡萄膜炎7例（4．22％）。可以确定病因或归于特定类型95例（57．23％），原因不明亦称为特发性葡萄膜炎71例（42．77％）。本研究应用免疫抑制剂有：环孢素、甲氨蝶呤、环磷酰胺、硫唑嘌呤。根据患者病情严重程度给予一种或几种联合应用。结果本研究患者应用免疫抑制剂治疗后症状都有不同程度减轻，最佳矫正视力、前房闪辉及前房炎症细胞都较用药前有所好转（P〈0．05），未出现严重不良反应。结论免疫抑制剂治疗葡萄膜炎疗效较好，但需定期监测多种指标并及时处理出现的不良反应。

Objective To observe the efficacy and safety of immunosuppressants in the treatment of uveitis. Methods One hundred and sixty-six uveitis patients（258 eyes） were enrolled in this study. Of the 166 patients, 78 cases（46. 99% ） of anterior uveitis, 70 cases（42. 17% ） of panuveitis, 11 cases （6. 63% ） of intermediate uveitis and 7 cases （4.22%） of posterior uveitis. Etiological study was performed in all of the patients. Ninty-five patients （57.23%） had specific diagnosis. No apparent cause was found in 71 patients （42.77%） and they were diagnosed as idiopathic uveitis. Cyclosporine A （ CsA）, methotrexate （ MTX）, cyclophosphamide, azathioprine （AZA） was used for this study. According to the severity of the disease, patients were given one or several joint application. Results The symptoms were relieved in different degree after treated with immunosuppressants. The best corrected vis- ual acuity, anterior chamber flare and inflammatory cells in the anterior chamber were improved compared with before treatment. There was no significant adverse reactions in this study. Conclusions The effectiveness of immunosuppressants on uveitis is better. But the patients must examine multi-index notation timely in the treatments and treatment of adverse reactions.