CAJ | 학술논문

目的探讨眼瘢痕性类天疱疮(OCP)的临床特点.方法回顾性系列病例研究.回顾2005年1月至2008年10月于北京大学第一医院眼科和皮肤科联合确诊为OCP的系列病例5例(10只眼)患者的病史、眼科常规检查、结膜囊细菌培养及全身免疫学常规检查的结果,分析其误诊原因.结果确诊前,5例患者在早期均误诊为慢性结膜炎,在这些病例瘢痕较明显时,1例曾被误诊为Stevens-Johnson综合征,1例误诊为干燥综合征,患者从首次就诊至确诊的时间长达2～5年.在确诊前均经过长期抗菌滴眼液的局部治疗,1例经3次内翻倒睫矫正术,术后病情加重.5例患者中诊断为OCPⅡ期3只眼、Ⅲ期5只眼、Ⅳ期2只眼,3例患者结膜囊细菌培养阳性,仅1例患者肿瘤标记物铁蛋白轻度升高,其余患者常规免疫学检查均正常.确诊后经合理治疗病情控制,但2例患者结膜瘢痕继续进展.结论 OCP早期表现类似慢性结膜炎,提高对OCP的警惕和认识是避免误诊的重要手段.
목적 탐토안반흔성류천포창(OCP)적림상특점.방법 회고성계렬병례연구.회고2005년1월지2008년10월우북경대학제일의원안과화피부과연합학진위OCP적계렬병례5례(10지안)환자적병사、안과상규검사、결막낭세균배양급전신면역학상규검사적결과,분석기오진원인.결과 학진전,5례환자재조기균오진위만성결막염,재저사병례반흔교명현시,1례증피오진위Stevens-Johnson종합정,1례오진위간조종합정,환자종수차취진지학진적시간장체2～5년.재학진전균경과장기항균적안액적국부치료,1례경3차내번도첩교정술,술후병정가중.5례환자중진단위OCPⅡ기3지안、Ⅲ기5지안、Ⅳ기2지안,3례환자결막낭세균배양양성,부1례환자종류표기물철단백경도승고,기여환자상규면역학검사균정상.학진후경합리치료병정공제,단2례환자결막반흔계속진전.결론 OCP조기표현유사만성결막염,제고대OCP적경척화인식시피면오진적중요수단.
Objective To analyze the clinical characterization of ocular cicatricial pemphigoid (OCP). Methods It was a retrospective series case study. Five consecutive patients referred for the evaluation of possible OCP from January 2005 to October 2008 in Departments of Ophthalmology and Dermatology of Peking University First Hospital History and clinical characterization of 5 cases ( 10 eyes) OCP having been misdiagnosed were analyzed to find the causes of misdiagnosis. Results All of cases were diagnosed as chronic conjunctivitis during the early stages of the diseases, one case was diagnosed as Stevens-Johnson syndrome and one as Sj(o)gren syndrome during the later stage. It was two to five years from the first time to see a doctor to definite diagnosis. All of cases have been prescribed antibiotic eye drops for a long times, one case has been undergone three times trichiasis operation and made the disease progression.Among the five patients with OCP, 3 eyes were diagnosed Stage Ⅱ , 5 eyes Stage Ⅲ, 2 eyes Stage Ⅳ. Three cases were positive of bacterial culture. Only in 1 case, there was slight increase of iron protein as tumor mark. Inflammation was controlled by the end of the study, but cicatrization of 2 cases still progressed.Conclusion Manifestation of OCP can mimic chronic conjunctivitis during the early stages, it is important to pay high attention to OCP, misdiagnosis may be stopped.