68例眼梅毒患者临床诊断的文献分析及其防治对策

Literature Analysis of Clinical Diagnosis in 68 Patients with Ocular Syphilis and Its Prevention and Treatment Countermeasure

目的:分析眼梅毒患者的临床诊断特征,为临床防治眼梅毒提供参考。方法:通过计算机检索中国知网(CNKI)、万方数据库(Wangfang Data)等数据库中"眼梅毒""临床诊断""抗梅毒治疗""梅毒螺旋体""视神经炎""视神经萎缩"等关键词,搜索近10年内国内外关于眼梅毒有关的文献资料,采用Excel 2007版和SPSS 20.0版统计学软件,分析其眼科相关检查和皮肤科相关检查,以及腰椎穿刺的病理学检查结果。结果:阅读全文根据纳入标准和有效信息的提取最终纳入12篇文章涉及68例患者,多以眼后段病变为主,其中视神经萎缩占多数。结论:梅毒的眼部损害为多种多样,缺乏特异性;对于病因不明的视力下降、眼部炎症等病症应排除眼梅毒的存在;梅毒应作为视神经炎的一个鉴别因素,一旦被确诊为眼梅毒,则应按照神经梅毒临床路径采用规范化的抗梅毒治疗。

Objective: To analyze the clinical characteristics of ocular syphilis and to provide a reference for clinical prevention and treatment of ocular syphilis. Methods: Key words such as "ocular syphilis", "clinical diagnosis", "antisyphilis treatment", "treponema pallidum", "optic neuritis" and "optic atrophy" in CNKI, Wangfang Data and other databases were searched by computer. The literatures related to ocular syphilis in recent 10 years at home and abroad have been searched, and statistical software Excel 2007 and SPSS 20.0 have been used to analyze the ophthalmic examination,dermatological examination and pathological examination results of lumbar puncture. Results: According to the inclusion criteria and extraction of effective information, 68 patients were eventually included in the 12 articles, most of whom were posterior segment lesions, with optic nerve atrophy accounting for the majority. Conclusion: The ocular lesions of syphilis were diverse and lack of specificity. For the cause of unknown vision loss, eye inflammation and other diseases should be excluded from the existence of syphilis;syphilis should be regarded as a distinguishing factor of optic neuritis. Once it is diagnosed as ocular syphilis, standardized anti-syphilis therapy should be adopted based on the clinical pathway of neurosyphilis.