CAJ | 학술논문

目的观察自身免疫性视神经病的临床特点.方法回顾分析2006年1月至2007年12月我院自身免疫性视神经病住院患者58例的临床资料.通过眼科和神经内科常规检查,视野、自身免疫抗体、头颅MRI等检查,对入组患者视力损害特点、视神经外临床和临床下受累情况等进行分析总结.结果 58例患者共93只眼受累,住院期间最差的最佳矫正视力(BCVA)在0.1以下者68只眼,占73.1%;伴有神经系统其他表现者10例,占17.2%;伴有神经系统外其他临床症状者14例,占24.1%.实验室检查结果显示ANA阳性者43例,占79.6%;其他异常抗体包括:抗十燥综合症抗原A或抗原B抗体、抗双链DNA抗体、抗组蛋白抗体、抗心磷脂抗体和HLA-B27.诊断符合系统性结缔组织病者20例,占34.5%,其中以干燥综合征、系统性红斑狼疮和白塞病较为常见.伴有头颅MRI异常者32例,占55.2%.住院治疗后BCVA明显好转者49只眼,占77.7%.结论自身免疫性视神经病视功能受累多较重.部分患者伴有其他系统以及神经系统其他部位损害的表现.部分为系统性结缔组织病累及视神经,其余多数表现为孤立性自身免疫性视神经病.
목적 관찰자신면역성시신경병적림상특점.방법 회고분석2006년1월지2007년12월아원자신면역성시신경병주원환자58례적림상자료.통과안과화신경내과상규검사,시야、자신면역항체、두로MRI등검사,대입조환자시력손해특점、시신경외림상화림상하수루정황등진행분석총결.결과 58례환자공93지안수루,주원기간최차적최가교정시력(BCVA)재0.1이하자68지안,점73.1%;반유신경계통기타표현자10례,점17.2%;반유신경계통외기타림상증상자14례,점24.1%.실험실검사결과현시ANA양성자43례,점79.6%;기타이상항체포괄:항십조종합증항원A혹항원B항체、항쌍련DNA항체、항조단백항체、항심린지항체화HLA-B27.진단부합계통성결체조직병자20례,점34.5%,기중이간조종합정、계통성홍반랑창화백새병교위상견.반유두로MRI이상자32례,점55.2%.주원치료후BCVA명현호전자49지안,점77.7%.결론 자신면역성시신경병시공능수루다교중.부분환자반유기타계통이급신경계통기타부위손해적표현.부분위계통성결체조직병루급시신경,기여다수표현위고립성자신면역성시신경병.
Objective To observe the clinical features of autoimmune optic neuropathy (AON).Methods The clinical data of 58 patients with AON from Jan.2006 to Dec.2007 were retrospectively analyzed.The patients had undergone routine ophthalmological,neurological examination,visual field test,all set of autoimmune antibody test,brain MRI.Results In 93 eyes of 58 patients with AON,the lowest best corrected visual acuity (BCVA) was＜0.1 in 68 eyes (73.1%),10 patients (17.2%) had other symptoms of nervous system,14 patients (24.1%) had lesions of non-neurological system.Positive antinuclear antibody was found in 43 patients (79.6%);other abnormal antibodies were also found,including anti-SSA/SSB,anti-ds-DNA,antihistonic,anticardiolipin,and anti-human leukocyte antigen B27antibodies.Systematic connective tissue disease presented in 20 patients (34.5%),such as sicca syndrome,systemic lupus erythematosus,and Behcet disease.32 patients (55.2%) had abnormal brain MRI,and the BCVA of 49 eyes (77.7%) improved significantly after hospitalization.Conclusion Patients with AON always have poor visual function,some of whom associate with other systems,as well as damages to other parts of the nervous system.While some AON patients are secondary to systemic connective tissue disease involving the optic nerve,the majority of these patients are isolated autoimmune optic neuropathy.