累及眼部的Stevens-Johnson综合征(附22例分析)

The ocular involvement of Stevens-Johnson syndrome

目的 :对 2 2例累及眼部的Stevens Johnson综合征 (SJS)作一初步临床分析。方法 :收集 1990～ 2 0 0 0住院的SJS病例 10 5例。回顾性分析其中眼部受累的患者 2 2例 (占 2 0 95 % )。根据致敏药物、发病前所患疾病、临床表现、实验室检查总结分析其可能的病因、眼部表现规律及治疗。结果 :累及眼部的 2 2例SJS病人中 ,肯定或可能是药物过敏引起的占 86 3 6% ,其中 ,抗生素类占 45 45 %。眼部充血是最常见的体征占 10 0 % ,有 5 0 %的病人结膜和 /或角膜形成假膜 ,视力下降占 3 1 82 %。眼部治疗主要是应用抗感染和人工泪液治疗。结论 :药物过敏是SJS最常见的原因。以结膜充血和假膜形成为特征的卡他性结膜炎是SJS眼部受累的最常见表现 ,重者可导致视力下降 ,早期合理的眼部治疗对预防晚期并发症非常重要。

Objective:To analyze the ocular involvement of Stevens-Johnson syndrome(SJS). Methods:22 patients with ocular involvement(20.95%)from all 105 hospitalized cases of SJS were retrospectively analyzed on the items of allergic drug,basic disease,clinical symptoms and signs and laboratory studies.The possible etiology,features of ocular manifestations and treatments were summarized. Results:among the 22 cases,86 36% of patients were positively or possibly induced by drugs,in which antibiotics accounted for 45 45%.The most common feature was conjunctival hyperemia.Pseudo-membranes in conjunctiva and/or cornea could be found in 50% of patients.The visual acuities of 31 82% of the patients dropped.The major methods of ocular treatment were antibiotics and artificial tear. Conclusions:SJS is a severe cutaneomucosal syndrome.Allergic drug was the most widely considered etiologic factor.Ocular involvement was common and may lead to visual drop in SJS patients.Appropriate ocular treatment in early stage was important to prevent from the ocular complications.