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[肾移植患者报告。肾病及免疫抑制治疗引起的眼部变化(作者译)]

[Report on renal transplant patients. Ocular changes due to renal disease and immunosuppressive therapy (author's transl)].

作者信息

Bettelheim H, Grabner G, Kopsa H, Schmidt P, Zazgornik J, Balcke P, Pils P

出版信息

Klin Monbl Augenheilkd. 1979 Feb;174(2):236-9.

PMID:374846
Abstract

51 patients with renal transplants were examined ophthalmologically 31,1 (1--77) months after the transplantation. 80,4 p. c. showed ocular complications: cataract formation in 43,1 p. c. of the patients examined and increased intraocular pressure values between 22 and 30 mm Hg in 3 patients are to be attributed to the systemic immunosuppressive therapy. Further ocular changes were recurrent subconjunctival haemorrhages due to increased vascular rigidity, calcium phosphate deposits in the conjunctiva due to persistant secondary hyperparathyroidism and fundus changes (pigmentary irregularities in the foveal regions, narrow arterial vessels). Although marked arterial hypertension was observed in 21 patients after the transplantation, no signs of hypertensive retinopathy could be found. Despite the high incidence of ocular complications after renal transplantation the risks of immunosuppressive therapy must be considered as tolerable: cataract formation and increased intraocular pressure do not impair the positive effect of renal transplantation on ocular functions. Regular ophthalmological control examinations of renal transplant patients are advisable.

摘要

51例肾移植患者在移植后31.1(1 - 77)个月接受了眼科检查。80.4%的患者出现眼部并发症:43.1%接受检查的患者形成白内障,3例患者眼压值在22至30毫米汞柱之间升高,这归因于全身免疫抑制治疗。进一步的眼部变化包括由于血管硬度增加导致的反复结膜下出血、由于持续性继发性甲状旁腺功能亢进导致的结膜磷酸钙沉积以及眼底变化(黄斑区色素不规则、动脉血管变窄)。尽管移植后21例患者出现明显的动脉高血压,但未发现高血压视网膜病变的迹象。尽管肾移植后眼部并发症发生率很高,但免疫抑制治疗的风险仍被认为是可耐受的:白内障形成和眼压升高并不损害肾移植对眼部功能的积极影响。建议对肾移植患者进行定期眼科检查。

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