CAJ | 학술논문

目的探讨糖皮质激素联合免疫抑制剂治疗Vogt-小柳-原田(VKH)综合征的临床效果,寻找理想的治疗方案.方法选取2008年1月至2010年1月确诊为VKH综合征的44例(88只眼)初发和复发患者,根据病情的严重程度给予单独糖皮质激素或糖皮质激素联合环孢素A、环磷酰胺进行系统治疗,随访12～29个月,对治疗前后的视力、用药剂量和长短、毒副作用等情况进行同顾性分析.结果 14例初发性VKH综合征患者经系统的单纯糖皮质激素或联合免疫抑制剂治疗≥1年,视力均显著提高,92.9％的患者葡萄膜炎得到完全控制.30例复发患者治疗后,83.3％的患者视力有不同程度提高,86.7％的患者葡萄膜炎得到完全控制.初发患者治疗后的视力明显好于复发患者.结论 VKH综合征的初发轻症患者给予长期足量的糖皮质激素即可控制炎症；初发的严重和复发患者则根据病情程度早期给予糖皮质激素联合环孢素A、环磷酰胺进行系统治疗,效果理想,毒副作用小,是安全有效地治疗方案.
목적 탐토당피질격소연합면역억제제치료Vogt-소류-원전(VKH)종합정적림상효과,심조이상적치료방안.방법 선취2008년1월지2010년1월학진위VKH종합정적44례(88지안)초발화복발환자,근거병정적엄중정도급여단독당피질격소혹당피질격소연합배포소A、배린선알진행계통치료,수방12～29개월,대치료전후적시력、용약제량화장단、독부작용등정황진행동고성분석.결과 14례초발성VKH종합정환자경계통적단순당피질격소혹연합면역억제제치료≥1년,시력균현저제고,92.9％적환자포도막염득도완전공제.30례복발환자치료후,83.3％적환자시력유불동정도제고,86.7％적환자포도막염득도완전공제.초발환자치료후적시력명현호우복발환자.결론 VKH종합정적초발경증환자급여장기족량적당피질격소즉가공제염증；초발적엄중화복발환자칙근거병정정도조기급여당피질격소연합배포소A、배린선알진행계통치료,효과이상,독부작용소,시안전유효지치료방안.
Objective To evaluate the therapeutic effect of corticosteroids and immunosuppressive in Vogt-Koyanagi-Harada (VKH) syndrome.Methods Forty-four patients (88 eyes) diagnosed with VKH syndrome were collected in our hospital from January 2008 to January 2010.According to the severity of disease,all patients were treated with corticosteroids alone or corticosteroids combined with Cyclosporin A and cyclophosphamide systematically and followed up from 12 to 29 months.Visual acuity,dose and side effects of drugs were reviewed.Results According to treatment of corticosteroids and immunosuppressive for more than one year,visual acuity of 14 primary patients was improved significantly; uveitis of 92.9％ were controlled completely.A complete control of uveitis was achieved in 86.7％ and improved vision was seen in 83.3％ of the 30 recurrent patients.The visual acuity was better in the primary patients than the recurrent.Conclusions Intensive and prolonged systemic treatment with corticosteroids is recommended for the primary mild patients of VKH syndrome; but to the primary severe and recurrent cases,the treatment is effective with corticosteroids combined with cyclosporine A and cyclophosphamide early,and the toxic side effects is less.