CAJ | 학술논문

目的调查上海市获得性免疫缺陷综合征(艾滋病,AIDS)初诊患者的眼部并发症的发生情况,分析其损害视力的主要因素,为防治视力损伤提供依据.方法横断面研究.于2011年3月～2012年2月期间对上海市公共卫生临床中心就诊的AIDS初诊患者进行调查,进行一系列完整的眼科及全身检查.采用Snellen视力表检查裸眼远视力和最佳矫正远视力;采用裂隙灯和眼底镜进行眼前段和眼底检查.对录入数据按WHO视力损害标准分级,并分析肓和低视力损害的原因.对数据进行分类计数,求百分比,用卡方检验进行数据分析.结果 358例艾滋病初诊患者中,286名患者知情同意至眼科门诊参加检查,受检率79.9％.眼部并发症患病率58.4％(167/286),其中干眼症的患病率最高36.0％(103/286),其次是结膜炎19.9％(57/286)、巨细胞病毒性视网膜炎(CMVR) 8.39％ (24/286)等.致盲率据首位的是CMVR40.0％ (4/10),其次是均为30.0％(3/10)的视网膜微血管病变(HIVM)和青光眼等.致盲性眼病在CD4+F淋巴细胞水平低于250个/μl时高发.结论上海市AIDS初诊患者眼部并发症患病率高于美国等国家,CMVR是主要损害视力的原因,建议加快建立健全CMVR的筛查和诊治网络,提高AIDS患者的生存质量.
목적 조사상해시획득성면역결함종합정(애자병,AIDS)초진환자적안부병발증적발생정황,분석기손해시력적주요인소,위방치시력손상제공의거.방법 횡단면연구.우2011년3월～2012년2월기간대상해시공공위생림상중심취진적AIDS초진환자진행조사,진행일계렬완정적안과급전신검사.채용Snellen시력표검사라안원시력화최가교정원시력;채용렬극등화안저경진행안전단화안저검사.대록입수거안WHO시력손해표준분급,병분석황화저시력손해적원인.대수거진행분류계수,구백분비,용잡방검험진행수거분석.결과 358례애자병초진환자중,286명환자지정동의지안과문진삼가검사,수검솔79.9％.안부병발증환병솔58.4％(167/286),기중간안증적환병솔최고36.0％(103/286),기차시결막염19.9％(57/286)、거세포병독성시망막염(CMVR) 8.39％ (24/286)등.치맹솔거수위적시CMVR40.0％ (4/10),기차시균위30.0％(3/10)적시망막미혈관병변(HIVM)화청광안등.치맹성안병재CD4+F림파세포수평저우250개/μl시고발.결론 상해시AIDS초진환자안부병발증환병솔고우미국등국가,CMVR시주요손해시력적원인,건의가쾌건립건전CMVR적사사화진치망락,제고AIDS환자적생존질량.
Objective To study the eye complication situation of patients initially diagnosed with Acquired Immunodeficiency Syndrome (AIDS); to analyze the main factors that cause damage to eyesight; and to provide a basis for the prevention and control of damage to vision in Shanghai.Methods This was a cross-sectional investigation.A cohort study of patients initially diagnosed with AIDS was conducted in the Shanghai public health clinic center from March 2011 to February 2012.The patients underwent a full and thorough set of ophthalmology examinations.Natural and best corrected distance vision were tested with a Snellen chart.The anterior segment and fundus were examined by slit lamp microscopy and direct ophthalmoscopy.The data were input in compliance with the WHO visual impairment standard classification,and the causes of blindness and low vision damage were analyzed.The data were collected and measured by percentage,and analyzed with a chi-square test.Results Among 358 patients initially diagnosed with AIDS,286 patients (79％)signed an informed consent to allow the eye clinic to examine them.Of the 286 patients,58.4％ had ocular complications.The highest incidence was 36.01％ for dry eyes,the second highest was 19.9％for conjunctivitis and the third was 8.39％ for cytomegalovirus retinitis (CMVR).The leading cause of blindness was 40％ from CMVR and the second leading causes were 30％ from retinal microvascular lesions (HIVM) and glaucoma.The rate of blindness increased with a CD4+T lymphocyte level less than 250 cells/μl.Conclusion The ocular complications in patients initially diagnosed with AIDS in Shanghai are higher than in the United States and other countries.CMVR was the main reason for damage to eyesight.It is recommended to move more quickly to establish a reliable CMVR screening and treatment network to improve the quality of life of AIDS patients.