275例儿童视神经炎患者流行病学及临床特征分析
投稿时间:2016-02-28  修订日期:2016-03-03  点此下载全文
引用本文:杨超,方凯,孙可欣,丛衡日,李红阳,秦雪英,吴涛,张晓君,魏世辉,胡永华.275例儿童视神经炎患者流行病学及临床特征分析[J].医学研究杂志,2016,45(9):55-59
DOI: 10.11969/j.issn.1673-548X.2016.09.015
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作者单位E-mail
杨超 100191 北京大学公共卫生学院流行病与卫生统计学系  
方凯 100013 北京市疾病预防控制中心  
孙可欣 100191 北京大学公共卫生学院流行病与卫生统计学系  
丛衡日 100730 首都医科大学附属北京同仁医院神经内科  
李红阳 100853 北京, 中国人民解放军总医院眼科中心  
秦雪英 100191 北京大学公共卫生学院流行病与卫生统计学系  
吴涛 100191 北京大学公共卫生学院流行病与卫生统计学系  
张晓君 100730 首都医科大学附属北京同仁医院神经内科  
魏世辉 100853 北京, 中国人民解放军总医院眼科中心 weishihui706@hotmail.com 
胡永华 100191 北京大学公共卫生学院流行病与卫生统计学系 yhhu@bjmu.edu.cn 
基金项目:国家科技支撑计划项目(2012BAI08B06)
中文摘要:目的 了解儿童视神经炎(ON)患者的流行病学及临床特征,为ON患儿的早期诊疗提供科学依据。方法 收集2010年11月~2014年1月就诊于全国17家医院的275例(414眼)儿童ON患者的临床资料,记录其人口学特征、病因分型、前驱病史、临床症状、眼科和影像学检查结果及预后情况,进行回顾性分析。结果 275例患者中男女性别发病比为1:1.24。发病年龄为2~15岁,以6岁及以上为主(94.5%)。儿童ON发病主要集中在秋、冬季节(64.4%),夏季较少(11.6%)。216例(78.5%)患者符合特发性ON诊断标准。单眼发病者136例(49.5%),双眼同时或相继发病者139例(50.5%)。80例(29.1%)患者在发病前3个月内有前驱病史。270例(377眼)进行了视力检查,201眼(53.3%)视力<0.1;271例(406眼)进行了眼底镜检查,299眼(73.6%)出现视神经乳头炎。视神经、脊髓和头颅3个部位在MRI检查中出现异常的比例分别为55.0%、41.2%和25.4%,差异有统计学意义(χ2=29.602,P<0.013)。随访82眼发病3个月后的最佳恢复情况,71眼(86.6%)的视力得到恢复。结论 儿童ON好发于6岁及以上的女性,以特发性ON为最常见的病因类型,单眼和双眼发病比例接近,以视力下降严重、视神经乳头炎为主要的临床特征,预后效果较好。
中文关键词:视神经炎  儿童  流行病学  临床特征
 
Analysis on Epidemiology and Clinical Characteristics of 275 Cases with Children Optic Neuritis
Abstract:Objective To explore the epidemiologic and clinical characteristics of children with optic neuritis (ON), and provide scientific evidence for their early diagnosis and treatment. Methods Clinical data of 275 cases (414 eyes) with children ON from Nov. 2010 to Jan. 2014 in 17 hospitals in China were collected and retrospectively analyzed, recording their demographic characteristics, etiological distributions, prodromal histories, clinical symptoms, ophthalmic and imaging examinations, and prognosis. Results Among the 275 patients, the male to female ratio was 1: 1.24. The majority (94.5%) were 6 years and older, with ages of onset ranging from 2 to 15 years. The incidence of ON was highest (64.4%) in the autumn and winter, and lowest (11.6%) in the summer. There were 216 children (78.5%) with idiopathic ON. 136 cases (49.5%) had unilateral disease, and 139 cases (50.5%) had bilateral disease. Prodromal histories within 3 months before the onset of ON were reported in 80 cases (29.1%). Of 270 cases (377 eyes) performed visual acuity test, 201 eyes (53.3%) had visual acuity less than 0.1. Of 271 cases (406 eyes) observed by funduscopy, papillitis was evident in 299 eyes (73.6%). The abnormal proportion of the optic nerve, the spinal cord and the skull in the MRI examination were 55.0%, 41.2%, and 25.4% respectively, and the difference was statistically significant (χ2=29.602,P<0.013). Optimal recoveries of 82 eyes after 3 months were followed up, with visual acuity recovered in 71 eyes (86.6%). Conclusion Children ON occurred in females at the age of 6 years and older. Idiopathic ON was the most common pathogeny of children ON. The proportion of unilateral disease was close to that of bilateral disease. The main clinical symptoms were characterized by severe vision loss and papillitis. Children with ON had a relatively good visual prognosis.
keywords:Optic neuritis  Children  Epidemiology  Clinical characteristics
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