2型糖尿病患者糖尿病视网膜病变不同时期外周血内皮祖细胞的数量变化

Objective To observe the amount of endothelial progenitor cells(EPCs)at different stages of diabetic retinopathy(DR)in patients with type 2 diabetes mellitus(DM).Methods Sixty patients with type 2 DM were divided into no DR(NDR)group,non-proliferative DR(NPDR)group and proliferative DR(PDR)group according to the examination of fundus and fundus fluorescein angiography,20patients in each group.Twenty healthy people were collected as the control group.6 ml blood samples were taken from all the subjects,and then the EPCs contents in peripheral blood were detected by flow cytometry.Results The EPCs contents in peripheral blood of the control,NDR,NPDR and PDR group were(0.0179±0.0047)% ,(0.0151±0.0086)% ,(0.0123±0.1137)% ,(0.0316±0.0294)% .The EPCs contents in peripheral blood of the PDR group was significantly higher than those in others(χ2=43.780,P＜0.05);the EPCs contents in peripheral blood of the NDR and NPDR group were slightly lower than that in the control group(χ2=5.244,P=0.73);the EPCs contents in peripheral blood of the NPDR group was lower than that in the NDR group(χ2=6.0 1 6,P=0.12).Conclusion The EPCs contents in peripheral blood decreases in NDR,NPDR patients,while significantly increases in PDR patients.     

2型糖尿病患者糖尿病视网膜病变不同时期外周血内皮祖细胞的数量变化

目的 观察2型糖尿病患者糖尿病视网膜病变(DR)不同时期外周血内皮祖细胞(EPCs)的数量变化.方法 临床确诊为2型糖尿病的60例患者纳入研究.根据眼底及荧光素眼底血管造影(FFA)检查结果,将患者分为无视网膜病变(NDR)组、非增生型DR(NPDR)组及增生型DR(PDR)组,每组各20例.选择同期门诊体检正常者20名作为对照组.抽取所有受检者晨起空腹静脉血6 ml,采用流式细胞仪检测,并比较4组受检者外周血EPCs数量的变化情况.结果 对照组、NDR、NPDR及PDR组受检者外周血EPCs数量分别为(0.0179±0.0047)%、(0.0151±0.0086)%、(0.0123±0.1137)%、(0.0316±0.0294)%;PDR组受检者外周血EPCs数量较其他3组高,差异有统计学意义(x2=43.780,P＜0.05);NDR、NPDR组受检者外周血EPCs数量略低于对照组,差异无统计学意义(x2=5.244,P=0.73);NPDR组受检者外周血EPCs数量低于NDR组,但差异也无统计学意义(x2=6.016,P=0.12).结论 NDR、NPDR患者外周血EPCs数量降低,PDR患者外周血EPCs数量显著增高.

Abstract：

Objective To observe the amount of endothelial progenitor cells(EPCs)at different stages of diabetic retinopathy(DR)in patients with type 2 diabetes mellitus(DM).Methods Sixty patients with type 2 DM were divided into no DR(NDR)group,non-proliferative DR(NPDR)group and proliferative DR(PDR)group according to the examination of fundus and fundus fluorescein angiography,20patients in each group.Twenty healthy people were collected as the control group.6 ml blood samples were taken from all the subjects,and then the EPCs contents in peripheral blood were detected by flow cytometry.Results The EPCs contents in peripheral blood of the control,NDR,NPDR and PDR group were(0.0179±0.0047)% ,(0.0151±0.0086)% ,(0.0123±0.1137)% ,(0.0316±0.0294)% .The EPCs contents in peripheral blood of the PDR group was significantly higher than those in others(χ2=43.780,P＜0.05);the EPCs contents in peripheral blood of the NDR and NPDR group were slightly lower than that in the control group(χ2=5.244,P=0.73);the EPCs contents in peripheral blood of the NPDR group was lower than that in the NDR group(χ2=6.0 1 6,P=0.12).Conclusion The EPCs contents in peripheral blood decreases in NDR,NPDR patients,while significantly increases in PDR patients.     

增生型糖尿病视网膜病变患者外周血内皮祖细胞的数量变化及意义

Objective To investigate the amounts of endothelial progenitor cells(EPCs)in peripheral blood of patients with proliferative diabetic retinopathy(PDR).Methods Forty patients with PDR(PDR group),thirty patmnts with type 2 diabetes mellitus(DM)without DR(DM group),and twenty agematched normal subjects(control group)were enrolled in this study.Blood samples were treated bv repeated centrifugation and stained with monoclonal antibodies.At least 2 × 105 cells were analyzed bv flow cytometry.EPCs were identified by CD34 and CD133 antibody.The correlation between EPCs numbers and DR duration,glycosylated hemoglobin,serum lipids was analyzed.Results The number of EPCs in PDR,DM and control group were(49±12)、(35±11)、(90±25)cells/ml respectively,the difference was statistically significant(F=56.260,P=0.000).There was a positive correlation between EPCs numbers and DR duration(r=0.564,P＜0.05).However there was no correlation between EPCs numbers and glycosylated hemoglobin(r=-0.170,P>0.05)or triglyceride levels(r=0.261,P>0.05).Conclusions The number of EPCs in peripheral blood of PDR patients was decreased. EPCs might play an important role in the pathogenesis of PDR.     

增生型糖尿病视网膜病变患者外周血内皮祖细胞的数量变化及意义

Objective To investigate the amounts of endothelial progenitor cells(EPCs)in peripheral blood of patients with proliferative diabetic retinopathy(PDR).Methods Forty patients with PDR(PDR group),thirty patmnts with type 2 diabetes mellitus(DM)without DR(DM group),and twenty agematched normal subjects(control group)were enrolled in this study.Blood samples were treated bv repeated centrifugation and stained with monoclonal antibodies.At least 2 × 105 cells were analyzed bv flow cytometry.EPCs were identified by CD34 and CD133 antibody.The correlation between EPCs numbers and DR duration,glycosylated hemoglobin,serum lipids was analyzed.Results The number of EPCs in PDR,DM and control group were(49±12)、(35±11)、(90±25)cells/ml respectively,the difference was statistically significant(F=56.260,P=0.000).There was a positive correlation between EPCs numbers and DR duration(r=0.564,P＜0.05).However there was no correlation between EPCs numbers and glycosylated hemoglobin(r=-0.170,P>0.05)or triglyceride levels(r=0.261,P>0.05).Conclusions The number of EPCs in peripheral blood of PDR patients was decreased. EPCs might play an important role in the pathogenesis of PDR.     

内皮型一氧化氮合酶基因第4内含子中27碱基对重复序列多态性与糖尿病视网膜病变的相关性研究

Objective To investigate the relationship between diabetic retinopathy(DR)and insertion/deletion(a/b)polymorphism of a 27 base pair variable number tandem repeat(VNTR)in intron 4of the endothelial nitric oxide synthase(eNOS)gene.Methods 321 patients of type 2 diabetes mellitus with over 10 years duration(case group)and 146 normal subjects(control group)were enrolled in this study.All the clients are Han Chinese.The case group was divided into DR subgroup(1 54 patients)and non-DR (NDR)subgroup(167 patients)according to the results of indirect ophthalmoscope and fundus fluorescent angiography.The VNTR polymorphism in eNOS gene was determined by polymerase chain reaction(PCR)combined with 8% agarose gel electrophoresis.Then the b,a allele frequency and b/b.a/a.b/a allele frequency of two groups were compared,and its correlation with diseases were analyzed.Results The b allele frequency of the VNTR in intron 4 of eNOS gene in the DR group was significantly higher than that in the NDR group(χ2=4.745,P=0.029;OR=1.685,95% CI=1.050-3.905)and control group(χ2=6.958,P=0.008;OR=1.89l,95% CI=1.172-4.437);b/b allele frequency in the DR group was also significantly higher than that in the NDR group(χ2=4.811,P=0.028;OR=1.790,95% CI=1.060-4.645)and controI group(χ2=5.203,P=0.023;OR=1.859,95% CI=1.087-4.952).Conclusions The b allele and b/b genotype in intron 4 of eNOS gene in the Han Chinese are closely related to DR.     

内皮型一氧化氮合酶基因第4内含子中27碱基对重复序列多态性与糖尿病视网膜病变的相关性研究

Objective To investigate the relationship between diabetic retinopathy(DR)and insertion/deletion(a/b)polymorphism of a 27 base pair variable number tandem repeat(VNTR)in intron 4of the endothelial nitric oxide synthase(eNOS)gene.Methods 321 patients of type 2 diabetes mellitus with over 10 years duration(case group)and 146 normal subjects(control group)were enrolled in this study.All the clients are Han Chinese.The case group was divided into DR subgroup(1 54 patients)and non-DR (NDR)subgroup(167 patients)according to the results of indirect ophthalmoscope and fundus fluorescent angiography.The VNTR polymorphism in eNOS gene was determined by polymerase chain reaction(PCR)combined with 8% agarose gel electrophoresis.Then the b,a allele frequency and b/b.a/a.b/a allele frequency of two groups were compared,and its correlation with diseases were analyzed.Results The b allele frequency of the VNTR in intron 4 of eNOS gene in the DR group was significantly higher than that in the NDR group(χ2=4.745,P=0.029;OR=1.685,95% CI=1.050-3.905)and control group(χ2=6.958,P=0.008;OR=1.89l,95% CI=1.172-4.437);b/b allele frequency in the DR group was also significantly higher than that in the NDR group(χ2=4.811,P=0.028;OR=1.790,95% CI=1.060-4.645)and controI group(χ2=5.203,P=0.023;OR=1.859,95% CI=1.087-4.952).Conclusions The b allele and b/b genotype in intron 4 of eNOS gene in the Han Chinese are closely related to DR.     

糖尿病视网膜病变对大鼠循环外周血内皮祖细胞数量的影响

Objective To observe the effect of diabetic retinopathy on endothelial progenitor cells (EPCs)from peripheral blood.Methods Sixty male Wistar rats were divided into control group and diabetes group.The rats in diabetes group were induced with streptozotocin(STZ)injection for diabetic retinopathy model.Flow cytometry was used to identify and count the number of EPCs from peripheral blood at 1 week.1,3 and 6 months after injection.All eyeballs were examined by hematoxylin and eosin (HE)staining,periodic acid-Schiffs(PAS)staining of trypsin-digested retinal vessels flat preparation and transmission electron microscope.EPCs count,and the relationship between DR morphological changes and EPCs count were compared and analyzed.Results The quantity of EPCs from peripheral blood at 1 week,1,3 and 6 months after STZ injection were 25±7,28±8,39±7,43±7 cells per 200 000 monocytes respectively,which decreased compared with the control group 45±4 cells per 200 000 monocytes(F=8.933,P＜0.0 1).The quantity of EPCs was gradually increased at 1 week,1,3 and 6 months after STZ injection,accompanied with responsive pathological changes of retinal structure and vessels.The thickness of retina at 1 week and 1 month after injection were reduced slightly.The number of retinal ganglion cells reduced,with the time passing by.Endothelial cells were edema,mitochondrial was swollen,capillary basement membrane was thicken,lumen was significant stenosis,lumen occlusion and retinal artery aneurysm were observed at 6 months after STZ injection.Conclusion The number of EPCs increases gradually throughout the development of DR.     

糖尿病视网膜病变对大鼠循环外周血内皮祖细胞数量的影响

Objective To observe the effect of diabetic retinopathy on endothelial progenitor cells (EPCs)from peripheral blood.Methods Sixty male Wistar rats were divided into control group and diabetes group.The rats in diabetes group were induced with streptozotocin(STZ)injection for diabetic retinopathy model.Flow cytometry was used to identify and count the number of EPCs from peripheral blood at 1 week.1,3 and 6 months after injection.All eyeballs were examined by hematoxylin and eosin (HE)staining,periodic acid-Schiffs(PAS)staining of trypsin-digested retinal vessels flat preparation and transmission electron microscope.EPCs count,and the relationship between DR morphological changes and EPCs count were compared and analyzed.Results The quantity of EPCs from peripheral blood at 1 week,1,3 and 6 months after STZ injection were 25±7,28±8,39±7,43±7 cells per 200 000 monocytes respectively,which decreased compared with the control group 45±4 cells per 200 000 monocytes(F=8.933,P＜0.0 1).The quantity of EPCs was gradually increased at 1 week,1,3 and 6 months after STZ injection,accompanied with responsive pathological changes of retinal structure and vessels.The thickness of retina at 1 week and 1 month after injection were reduced slightly.The number of retinal ganglion cells reduced,with the time passing by.Endothelial cells were edema,mitochondrial was swollen,capillary basement membrane was thicken,lumen was significant stenosis,lumen occlusion and retinal artery aneurysm were observed at 6 months after STZ injection.Conclusion The number of EPCs increases gradually throughout the development of DR.     

增生型糖尿病视网膜病变患者外周血内皮祖细胞的数量变化及意义

目的 观察增生型糖尿病视网膜病变(PDR)患者外周血内皮祖细胞(EPCs)数量的变化规律,探讨EPCs在糖尿病视网膜病变(DR)发病机制中的作用.方法 PDR患者40例(PDR组)、单纯2型糖尿病患者30例(糖尿病组)及健康体检者20名(对照组)纳入研究.抽取3组受检者晨起空腹静脉血2 ml,反复离心过滤.采用流式细胞仪分析2×105个细胞,以CD34和(或)CD133双阳性细胞群为EPCs,观察并比较3组受检者外周血EPCs数量变化;同时分析PDR患者外周血EPCs数量与DR病程、糖化血红蛋白及血脂的相关性.结果 PDR组、糖尿病组及对照组受检者外周血EPCs计数分别为(49±12)、(35±11)、(90±25)个/ml,3组间差异有统计学意义(F=56.260,P＜0.05).相关性分析发现,PDR患者外周血EPCs数量与DR病程呈正相关(r=0.564,P＜0.05),与糖化血红蛋白(r=-0.170,P>0.05)及血脂(r=0.261,P>0.05)均无相关性.结论 PDR患者外周血EPCs数量较正常者明显降低;EPCs在DR发病机制中可能具有一定作用.

Abstract：

Objective To investigate the amounts of endothelial progenitor cells(EPCs)in peripheral blood of patients with proliferative diabetic retinopathy(PDR).Methods Forty patients with PDR(PDR group),thirty patmnts with type 2 diabetes mellitus(DM)without DR(DM group),and twenty agematched normal subjects(control group)were enrolled in this study.Blood samples were treated bv repeated centrifugation and stained with monoclonal antibodies.At least 2 × 105 cells were analyzed bv flow cytometry.EPCs were identified by CD34 and CD133 antibody.The correlation between EPCs numbers and DR duration,glycosylated hemoglobin,serum lipids was analyzed.Results The number of EPCs in PDR,DM and control group were(49±12)、(35±11)、(90±25)cells/ml respectively,the difference was statistically significant(F=56.260,P=0.000).There was a positive correlation between EPCs numbers and DR duration(r=0.564,P＜0.05).However there was no correlation between EPCs numbers and glycosylated hemoglobin(r=-0.170,P>0.05)or triglyceride levels(r=0.261,P>0.05).Conclusions The number of EPCs in peripheral blood of PDR patients was decreased. EPCs might play an important role in the pathogenesis of PDR.     

2型糖尿病并发视网膜病变患者血清缺血修饰白蛋白和超敏C-反应蛋白浓度的变化

Objective To explore the changes of the concentration of serum ischemia modified albumin(IMA) and high sensitivity C-reactive protein(hs-CRP) in type 2 diabetic patients with retinopathy (DR). Methods The concentration of serum IMA and hs-CRP in DR patients were determined by ELISA and ratenephetometry and compared with those in 83 no-DR (NDR) patients and 72 controls. The concentration of serum IMA and hs-CRP in 40 proliferative diabetic retinopathy (PDR) patients were compared with those in 39 no-PDR (NPDR) patients. Data was evaluated using analysis of PPMS version 1.5. Results are expressed as means ± standard deviation of the mean. Statistical comparisons were performed by student's t-test or one-way analysis of varrance followed by Dunnett's multiple comparison test and the means compared each other using q test. Results The serum IMA and hs-CRP concentration in DR patients were (46.51 ± 13.29) μg/L, (4.27 ±2.24) mg/L. The serum IMA and hs-CRP concentration in NDR patients were(25.47 ± 9. 33 ) μg/L, ( 2. 96± 1.84 ) mg/L. The serum IMA and hs-CRP concentration in controls were ( 15.36 ± 4.27 ) μg/L, ( 1.86 ±0. 97 ) mg/L. The serum IMA and hs-CRP concentration in PDR patients were(54. 72± 15.61 ) μg,/L, (6. 34 ± 3.53 ) mg/L. The serum IMA and hs-CRP concentration in NPDR patients were ( 38.35 ± 11.27 )μg/L, ( 3. 28 ± 1.77 ) mg/L. The serum IMA and hs-CRP concentration were significantly higher in DR patients than those in controls and NDR patients, the serum IMA and hs-CRP concentration in NDR patients were significantly higher than those in controls ( F = 197. 124,34. 561 ;q =5.41-27. 34;P <0. 01 ) ;the serum IMA and hs-CRP concentration were significantly higher in PDR patients than those in NPDR patients ( t = 5.46,4. 89 ;P < 0. 01 ) ;there was significant positive correlation between serum IMA concentration and hs-CRP concentration in DR patients( r =0. 617, P <0. 01 ). Conclusion The serum IMA and hs-CRP concentration were significantly high in DR patients, and were positively associated with the seriousness of DR, which may contribute to the development of DR.     

全氟萘烷液在眼内应用的实验研究

目的 探讨全氟萘烷(PFDL)在眼内存留不同时期眼组织结构、电生理改变及相关损伤机制.方法 选择白兔前房及玻璃腔内填充不同数量的PFDL,分别于术后6h、24h、72h、7d、30d、60d,对角膜和视网膜进行透射电镜检查,及角膜内皮镜和电生理检查.结果 术后24h到术后7d,观察到的病理改变为细胞水肿等变性反应;术后第30d、60d出现角膜内皮细胞密度显著下降,b波的振幅显著降低,角膜上皮及实质细胞坏死,细胞内质网扩张、脱颗粒,视网膜感光细胞膜盘变性、萎缩和坏死,细胞间及神经纤维层树突水肿等严重的不可逆的病理改变,在角膜内皮细胞和视网膜感光细胞发现有髓磷体的存在.结论 PFDL在眼内存留24h以上对视网膜及角膜有一定的毒性作用,其毒性作用机制与PFDL的重力压迫作用、产生自由基和PFDL破坏组织细胞的能量代谢有关,临床上不宜作眼内长期填充物.     

脉络膜黑色素瘤组织病理学分析

目的 观察脉络膜黑色素瘤的组织病理学特征。 方法 回顾分析64例病理确诊的脉络膜黑色素瘤病理资料。按照美国眼黑色素瘤多中心研究组的测量方法和WHO的分类标准，测量和观察大体标本中的肿瘤大小和光学显微镜下的肿瘤细胞学类型；以肿瘤前缘累及部位对肿瘤所处位置进行分类；以肿瘤细胞向外浸润程度对肿瘤蔓延程度进行分级。 结果 64例脉络膜黑色素瘤中，大肿瘤25例，占39.1%；中等大小肿瘤31例，占48.4%；小肿瘤8例，占12.5%。梭形细胞型42例，占65.6%,其中，梭形细胞A型15例,占23.4%，梭形细胞B型27例,占42.3%;上皮样细胞型7例,占10.9%;混合型10例,占15.6%;其它型5例,占7.8%。肿瘤细胞未累及巩膜者25例,占39.1%;累及巩膜但限于巩膜层内者22例,占34.4%;穿透巩膜全层达眼球表面者12例,占18.7%;眶内浸润者5例,占7.8%。 结论 脉络膜黑色素瘤组织病理学特征变化多样，临床上以梭形细胞型最常见，易伴巩膜浸润。 (中华眼底病杂志, 2006, 22: 161-165)     

前后段联合手术及硅油填充治疗高度近视黄斑孔视网膜脱离的疗效观察

目的 观察前后段联合手术及硅油充填治疗高度近视黄斑孔视网膜脱离临床疗效.方法 回顾分析前后段联合手术及硅油充填治疗高度近视黄斑孔视网膜脱离患者48例48只眼的临床资料.患者均有高度近视史,视网膜脱离以后极部为主.裂隙灯前置镜和(或)光相干断层扫描(OCT)检查均发现黄斑裂孔.均行白内障超声乳化或抽吸联合玻璃体切割硅油充填,41例行内界膜(ILM)剥离,23例植入人工晶状体(10L).硅油取出的时间距第一次手术时间为3.5～48.0个月.取硅油前均行OCT检查.取硅油后随访观察均1年以上.结果 除5例外,其他患者手术后1周,前置镜检查均不能看到黄斑孔边缘;视力均有不同程度的提高.48例患者全部已取硅油.取硅油前OCT检查,黄斑孔愈合呈U型8例,V型为6例,W型为23例;未闭合11例.未闭合的11例经取硅油与膨胀气体充填后全部复位,其中,U型2例,W型9例.32例W型愈合者中2例患者在取油后13、38个月后出现视网膜脱离复发.最终黄斑裂孔U型和V型愈合者16例,占33.3%;W型愈合者32例,占66.7%.视网膜复位率为100.0%.结论前后段联合手术及硅油充填是治疗高度近视黄斑孔视网膜脱离的有效方法 ;OCT检查是确定黄斑孔是否封闭的客观标准.     

病理性近视黄斑劈裂光相干断层扫描图像分型及其对临床的指导意义

病理性近视黄斑劈裂光相干断层扫描(OCT)的类组织学分型可以分为单纯外层劈裂、外层和中层劈裂、外层和内层劈裂、多层劈裂4种情况.以彻底清除玻璃体后皮质及后部血管弓内的内界膜为重点的玻璃体视网手术是治疗病理性近视黄斑劈裂的主要选择.其中,单纯外层劈裂合并中心凹脱离者,手术后视功能改善较明显;而多层劈裂者视功能改善有限或不改善.合理剥除后皮质与内界膜起始点,应在未发生内层劈裂处.正确认识和了解病理性近视黄斑劈裂的OCT分型.对于选择玻璃体视网膜手术方式和判断治疗预后有积极意义.     

壳聚糖神经保护机制研究进展

多种因素可造成视觉神经系统的不可逆性损伤,传统的治疗方法主要是药物疗法,但各种药物都存在着不同的优缺点.壳聚糖是一种生物相容性良好的天然阳离子多糖类聚合物,近来的研究表明,壳聚糖具有抗氧化、抗凋亡和抗神经炎的生物学特性,能够对各种原因导致的神经损伤发挥保护作用.就壳聚糖神经保护机制的研究进展进行综述.     

儿童白瞳症(附52例报告)

报告52例(61只眼)白瞳症。其中,男31例,38只眼;女21例,23只眼。患儿平均年龄7.7岁。病因以肿瘤为最多,共22例(22只眼),占42.3％;其次为各种先天性疾病,共12例(19只眼),占23％;另外还有外伤和炎症。44例采用手术治疗,8例用药物保守治疗。讨论了儿童白瞳症的主要病因。     

增生性玻璃体视网膜病变眼玻璃体中白细胞介素、肿瘤坏死因子含量变化及意义

】　Objective　To determine the concentration of interleukin-12(IL-12),interleukin-2(IL-2) and tumor necrosis factor(TNF)and their possible role in the pathogenesis of proliferative vitreoretinopathy(PVR) ．　Methods　Patients were divided into 3 groups18 with PVR,7 with simples retinal detachment caused by macular hole and 4 samples from normal eyes were used as control.Samples of vitreous were obtained by aspiration through pars plana before cryotherapy,vitrectomy and gas injection and stored in liquid nitrogen at －70℃ within 30 minites for ELISA.　Results　 ①The levels of IL-12,IL-2,and TNF in the vitreous of PVR were positively correlated with the degree of severity of disease.②The levels of IL-12,IL-2,and TNF in the PVR were higher than those in simple retinal detachment caused by macular hole and those in control group(P＜0.01).③The levels of IL-12,IL-2,and TNF in retinal detachment caused by macular hole were also higher than those in the control group(P＜0.01).　Conclusion　IL-12,IL-2,and TNF may play a role at lease to some extent in the pathogenesis of PVR.     

初期开展白内障超声乳化吸出术的并发症分析

目的 :通过对初期白内障超声乳化吸出术出现的并发症的分析 ,以期减少并发症的发生 ,提高手术效果。方法 :总结 40例白内障超声乳化术后的并发症。结果 :角膜水肿 38眼、后囊破裂 5眼 ,两者是最为常见的并发症。结论 :提示初期开展白内障超声乳化术应严格掌握手术指针     

正确合理使用糖皮质激素:一个眼底病治疗中仍需重视的问题

糖皮质激素是临床上治疗眼底疾病的重要手段之一,除了抑制炎症反应以外,近年来也被用来治疗各种病因引起的黄斑水肿、脉络膜新生血管等;为增加局部药物浓度,减少全身副作用,给药途径也更多地采用球周和玻璃体腔注射等.但是随着该类药物的应用范围扩大,由此而引起的临床问题也逐渐增多.正确合理使用糖皮质激素,仍然是一个眼底病治疗中值得重视的问题.临床医生在决定应用糖皮质激素治疗眼底病之前,应尽可能明确疾病诊断,充分了解糖皮质激素的药理特点,正确掌握适应证,明确并发症和禁忌症,重视球周和玻璃体腔注射等局部给药途径的局部和全身影响,从而充分发挥糖皮质激素的治疗作用,最大限度地减少其并发症的发生.     

正确合理使用糖皮质激素:一个眼底病治疗中仍需重视的问题

糖皮质激素是临床上治疗眼底疾病的重要手段之一,除了抑制炎症反应以外,近年来也被用来治疗各种病因引起的黄斑水肿、脉络膜新生血管等;为增加局部药物浓度,减少全身副作用,给药途径也更多地采用球周和玻璃体腔注射等.但是随着该类药物的应用范围扩大,由此而引起的临床问题也逐渐增多.正确合理使用糖皮质激素,仍然是一个眼底病治疗中值得重视的问题.临床医生在决定应用糖皮质激素治疗眼底病之前,应尽可能明确疾病诊断,充分了解糖皮质激素的药理特点,正确掌握适应证,明确并发症和禁忌症,重视球周和玻璃体腔注射等局部给药途径的局部和全身影响,从而充分发挥糖皮质激素的治疗作用,最大限度地减少其并发症的发生.