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[眼部受累结节病的临床分析]

[Clinical analyses of sarcoidosis with ocular involvement].

作者信息

Liu Xiaofang, Sun Yongchang, Dai Honglei, Jin Jianmin, Liu Yong

机构信息

Department of Respiratory Medicine, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China.

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出版信息

Zhonghua Yi Xue Za Zhi. 2014 Nov 4;94(40):3171-4.

Abstract

OBJECTIVE

To explore the clinical characteristics and systemic manifestations of sarcoidosis with ocular involvement.

METHODS

The clinical data of 19 cases of sarcoidosis with ocular involvement confirmed by pathology at Beijing Tongren Hospital from March 2004 to February 2014 were analyzed retrospectively. The ocular manifestations, chest imaging findings, laboratory tests and pathological diagnosis were reviewed. And the clinical features of sarcoidosis with ocular involvement were summarized.

RESULTS

Among them, there were 6 males and 13 females with an average age of (47 ± 14) (16-76) years. The ocular symptoms were the initial presenting manifestations of sarcoidosis in 12 cases while 2 cases presented ocular symptoms during the course of disease. And aother 5 cases without ocular symptoms were confirmed to have ocular involvement by eye examination. The main manifestations of ocular sarcoidosis were uveitis (n = 16), chorioretinitis (n = 3), retinal vasculitis (n = 2), optic neuritis (n = 1) and orbital mass (n = 3). The key feature of sarcoidosis was bilateral hilar lymphadenopathy (BHL) (14/16) on chest film. The diagnosis in 17 cases was confirmed by biopsy of extra-ocular organs. The positive diagnostic rate of bronchial biopsy was 8/9.

CONCLUSIONS

Ocular involvement in sarcoidosis is relatively common due to a variety of ocular manifestations and serious vision impairment in some patients. Ophthalmologic examination is essential in the clinical management of sarcoidosis. Chest imaging and bronchial biopsy are important for the diagnosis of sarcoidosis with initial ocular manifestations.

摘要

目的

探讨结节病眼部受累的临床特征及全身表现。

方法

回顾性分析2004年3月至2014年2月在北京同仁医院经病理确诊的19例结节病眼部受累患者的临床资料。对其眼部表现、胸部影像学检查结果、实验室检查及病理诊断进行分析,并总结结节病眼部受累的临床特点。

结果

其中男性6例,女性13例,平均年龄(47±14)(16 - 76)岁。12例患者眼部症状为结节病的首发表现,2例在病程中出现眼部症状,另外5例无眼部症状患者经眼部检查确诊有眼部受累。结节病眼部主要表现为葡萄膜炎(16例)、脉络膜视网膜炎(3例)、视网膜血管炎(2例)、视神经炎(1例)及眼眶肿物(3例)。胸部X线片显示结节病的关键特征为双侧肺门淋巴结肿大(14/16)。17例患者经眼外器官活检确诊。支气管活检阳性诊断率为8/9。

结论

结节病眼部受累较为常见,因眼部表现多样,部分患者视力严重受损。眼科检查在结节病临床管理中至关重要。胸部影像学检查及支气管活检对以眼部表现为首发的结节病诊断具有重要意义。

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