葡萄膜炎的临床类型及病因探讨

Studies on the etiologies and classification of uveitis

目的 探讨葡萄膜炎的临床类型、病因及其发病年龄和性别构成。 方法 对 1996年 1月至 2 0 0 1年 12月 ,于中山眼科中心葡萄膜炎专科就诊的葡萄膜炎患者的资料进行回顾性分析 ,特别是按照解剖位置分类并结合病因分类方法 ,对葡萄膜炎的病因、类型进行探讨 ,并就发病的年龄和性别等因素进行分析讨论。 结果 各种类型葡萄膜炎患者共计 12 14例 ,男 6 98人 ,女 5 16人 ,平均发病年龄 34.43岁。其中前葡萄膜炎 5 46例 ,占所有患者的 44 .98% ;全葡萄膜炎 5 30例 ,占 43.6 6 % ;中间葡萄膜炎 78例 ,占6 .43% ;后葡萄膜炎 6 0例 ,占 4.94%。能够确定病因或归于特定类型的患者共 70 3例 ,占 5 7.91% ,其余为特发性患者 5 11例。前葡萄膜炎中特发性患者最多 ,共 316例占 5 7.88% ,其次为 Fuchs综合征 85例和关节强直性脊椎炎 45例 ;全葡萄膜炎中最常见的类型为 Behcet ) 病 2 18例 (41.13% )和 Vogt-小柳原田综合征196例 (36 .98% ) ;中间和后葡萄膜炎均为特发性。 结论 葡萄膜炎多发于青壮年 ;男性患者整体上稍多于女性 ;常见类型为特发性前葡萄膜炎、Behcet ) 小柳原田综合征等 ;解剖位置结合病因进行分类是较为合理的葡萄膜炎分类方法。

Objective To study the clinical classification and etiologies of uveitis based on 1 214 uveitis patients reffered to Zhongshan Ophthalmic Center. Methods A retrospective analysis was made on the patients with uveitis, coming from all over China between January 1996 and December 2001. All kinds of uveitis were classified according to the anatomical criteria and etiological criteria. The relevant data of these patients, such as the age at uveitis onset and sex were also analyzed. Results The total number of the patients is 1 214 (male 698, female 516), with the average age at disease onset being 34.43. Anterior uveitis, the most common type, was seen in 546 cases, accounting for 44.98% of all the patients, followed in descending order by panuveitis (530 cases, 43.66%), intermediate uveitis(78 cases, 6.43%) and posterior uveitis(60 cases, 4.94%). Etiological factors and clinical entities were identified in 703 patients, accounting for 57.91% of all the patients, and the other 511 patients were idiopathic ones. The most common types of anterior uveitis were idiopathic uveitis(316 cases, 57.88%), followed by Fuchs syndrome(85 cases) and ankylosing spondylitis(45 cases). Behcet ) disease(218 cases, 41.13%) and Vogt-Koyanagi-Harada syndrome(196 cases, 36.98%) were the most common entities in panuveitis. Neither etiological factors nor clinical entities could be identified in the patients with intermediate uveitis and those with posterior uveitis. Conclusions Uveitis occurs mostly in young and middle-aged adults. In general, a predilection was seen in the male as compared with the female in the development of uveitis. Idiopathic anterior uveitis, Behcet ) disease and Vogt-Koyanagi-Harada syndrome are the most common entities of uveitis seen in China. Classification based on etiological and anatomical factors may provide a reasonable system for the study of uveitis.