我院非外伤性玻璃体积血病因分析
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摘要
目的分析我院非外伤性玻璃体积血的主要病因和特点。方法回顾性分析2013年1月～2017年12月我院非外伤性玻璃体积血363例(436眼)患者的临床资料,分析其病因及特点。结果增殖性糖尿病性视网膜病变(PDR)251眼,视网膜静脉阻塞(RVO)63眼,视网膜裂孔及脱离(RH/RD)33眼,息肉样脉络膜血管病变(PCV)33眼,以上4种原因共380眼,占87.2%,为非外伤性玻璃体积血的主要病因。男、女患者的玻璃体积血病因构成比较,差异无统计学意义(P>0.05)。PDR在各年龄组中均为首要发病原因,尤其在中年组中占有极大比例,其次为青年组。PDR呈逐年增加趋势。非PDR引起的玻璃体积血中,青年组最常见原因为Eales′s病,中老年组则以RVO最为常见。结论 PDR,RVO、RH/RD及PCV是我院非外伤性玻璃体积血的主要病因。不同年龄组导致玻璃体积血病因各有不同,其中PDR是各年龄组首要病因。PDR呈逐年增加趋势.。
Objective To analyze the etiological factors and features of non-traumatic vitreous hemorrhage in our hospital. Methods The clinical data of 436 eyes of 363 patients in our hospital with non-traumatic vitreous hemorrhage from January 2013 to December 2017 was studied for the etiological factors and features. Results Vitreous hemorrhage was found in 251 eyes of proliferative diabetic retinopathy(PDR), 63 eyes of retinal vein occlusion(RVO), 33 eyes of retinal hole or retinal detachment(RH/RD), 33 eyes of polypoidal choroidal vasculopathy(PCV), amounting to 87.2% of the total eyes. There was no significant difference in etiology of vitreous hemorrhage between male and female patients(P>0.05). PDR was the most common cause in all age groups, especially in the middle age group, followed by the yong group. The number of PDR increased year by year. The most common cause in non-PDR patients in young adults was Eales′ s disease, in middle and old ages was RVO. Conclusion The main causes of non-traumatic vitreous hemorrhagein our hospital are PDR, RVO, RH/RD and PCV. Different age groups have different causes, among which PDR is the most common cause. The number of PDR increases year by year.
Objective To analyze the etiological factors and features of non-traumatic vitreous hemorrhage in our hospital. Methods The clinical data of 436 eyes of 363 patients in our hospital with non-traumatic vitreous hemorrhage from January 2013 to December 2017 was studied for the etiological factors and features. Results Vitreous hemorrhage was found in 251 eyes of proliferative diabetic retinopathy(PDR), 63 eyes of retinal vein occlusion(RVO), 33 eyes of retinal hole or retinal detachment(RH/RD), 33 eyes of polypoidal choroidal vasculopathy(PCV), amounting to 87.2% of the total eyes. There was no significant difference in etiology of vitreous hemorrhage between male and female patients(P>0.05). PDR was the most common cause in all age groups, especially in the middle age group, followed by the yong group. The number of PDR increased year by year. The most common cause in non-PDR patients in young adults was Eales′ s disease, in middle and old ages was RVO. Conclusion The main causes of non-traumatic vitreous hemorrhagein our hospital are PDR, RVO, RH/RD and PCV. Different age groups have different causes, among which PDR is the most common cause. The number of PDR increases year by year.
引文
[1]于文贞,陈欢,赵敏,等.非外伤非糖尿病视网膜病变性玻璃体积血病因分析及手术疗效[J].中国实用眼科杂志,2011,29(3):262-266.
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[8]丁莉娟.非外伤性玻璃体积血的病因及手术治疗的效果[J].中华眼外伤职业眼病杂志,2016,38(5):376-380.
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[11]王叶楠,胡运韬,马志中,等.高龄严重玻璃体积血患者的病因分析[J].中华实验眼科杂志,2018,36(10):780-784.
[12]张鲁洁,陈莉,梁歌,等.中国北部地区严重玻璃体积血的病因及其影响因素的分析[J].国际眼科杂志,2017,17(12):2193-2196.
[13]刘子扬,叶俊杰.息肉状脉络膜血管病变并发玻璃体积血的机制研究[J].眼科新进展,2016,36(2):193-196.
[14]Jung JH,Lee JK,Lee JE,et al.Results of vitrectomy for breakthrough vitreous hemorrhage associated with age-related macular degeneration and polypoidal choroidal vasculopathy[J].Retina,2010,30(6):865-873.
[15]陶勇,侯婧,黎晓新.254例息肉样脉络膜血管病变的临床特征分析[J].中华眼底病杂志,2012,28(5):441-444.
[16]Sandhu SS,Manvikar S,Steel DH.Displacement of submacular hemorrhage associated with age-related macular degeneration using vitrectomy and submacular tPA injection followed by intravitreal ranibizumab[J].Clin Ophthalmol,2010,21(4):637-642.
[17]Cackett P,Htoon H,Wong D,et al.Haemorrhagic pigment epithelial detachment as a predictive feature of polypoidal choroidal vasculopathy in a Chinese population[J].Eye,2010,24(5):789-792.
[18]Laude A,Cackett PD,Vithana EN,et al.Polypoidal choroidal vasculopathy and neo-vascular age-related macular degeneration:same or different disease?[J].Prof Ret Eye Res,2010,29(1):19-29.
[19]Kimura S,Morizane Y,Hosokawa M,et al.Submacular hemorrhage in polypoidal choroidal vasculopathy treated by vitrectomy and subretinal tissue plasminogen activator[J].Am J Ophthalmol,2015,159(4):683-689.
[20]惠延年,王琳,冯学峰.玻璃体手术和眼内光凝治疗伴玻璃体积血和新生血管膜的视网膜静脉阻塞[J].中华眼底病杂志,1998,14(1):3-6.
[21]Clarkson JG.Central vein occlusion study:photographic protocol and early natural history[J].Trans Am Ophthalmol Soc,1994,(92):203-213.
[2]Sharma R,Joshi SN,Shrestha JK.Etiology of vitreous hemorrhage in a tertiary eye care center in Nepa[J].Nepal J Ophthalmol,2010,2(2):121-126.
[3]王建民,马景学,叶存喜,等.非外伤性玻璃体大量积血的病因分析[J].中国实用眼科杂志,2006,24(1):100-103.
[4]孙玉芹,程雪雁,李翠萍,等.老年人护理与保健[M].天津:天津科学技术出版社,2008:1-2.
[5]任增金,毕秀增,宋宗明,等.非外伤性严重玻璃体积血主要病因回顾性分析[J].中华眼底病杂志,2013,29(1):45-47.
[6]中华医学会糖尿病学分会视网膜病变学组.糖尿病视网膜病变防治专家共识[J].中华糖尿病杂志,2018,10(4):241-247
[7]郝琳娜,毕春潮,马为梅.非糖尿病患者非外伤性玻璃体积血病因分析[J].临床眼科杂志,2018,26(1):27-30.
[8]丁莉娟.非外伤性玻璃体积血的病因及手术治疗的效果[J].中华眼外伤职业眼病杂志,2016,38(5):376-380.
[9]王旭川,盛艳娟,王玉.非外伤性玻璃体积血的病因及手术疗效分析[J].2017,31(1):107-109.
[10]薛晓乐,黄宝玲.非糖尿病患者玻璃体积血126例病因分析[J].中国实用医刊,2018,45(21):50-52.
[11]王叶楠,胡运韬,马志中,等.高龄严重玻璃体积血患者的病因分析[J].中华实验眼科杂志,2018,36(10):780-784.
[12]张鲁洁,陈莉,梁歌,等.中国北部地区严重玻璃体积血的病因及其影响因素的分析[J].国际眼科杂志,2017,17(12):2193-2196.
[13]刘子扬,叶俊杰.息肉状脉络膜血管病变并发玻璃体积血的机制研究[J].眼科新进展,2016,36(2):193-196.
[14]Jung JH,Lee JK,Lee JE,et al.Results of vitrectomy for breakthrough vitreous hemorrhage associated with age-related macular degeneration and polypoidal choroidal vasculopathy[J].Retina,2010,30(6):865-873.
[15]陶勇,侯婧,黎晓新.254例息肉样脉络膜血管病变的临床特征分析[J].中华眼底病杂志,2012,28(5):441-444.
[16]Sandhu SS,Manvikar S,Steel DH.Displacement of submacular hemorrhage associated with age-related macular degeneration using vitrectomy and submacular tPA injection followed by intravitreal ranibizumab[J].Clin Ophthalmol,2010,21(4):637-642.
[17]Cackett P,Htoon H,Wong D,et al.Haemorrhagic pigment epithelial detachment as a predictive feature of polypoidal choroidal vasculopathy in a Chinese population[J].Eye,2010,24(5):789-792.
[18]Laude A,Cackett PD,Vithana EN,et al.Polypoidal choroidal vasculopathy and neo-vascular age-related macular degeneration:same or different disease?[J].Prof Ret Eye Res,2010,29(1):19-29.
[19]Kimura S,Morizane Y,Hosokawa M,et al.Submacular hemorrhage in polypoidal choroidal vasculopathy treated by vitrectomy and subretinal tissue plasminogen activator[J].Am J Ophthalmol,2015,159(4):683-689.
[20]惠延年,王琳,冯学峰.玻璃体手术和眼内光凝治疗伴玻璃体积血和新生血管膜的视网膜静脉阻塞[J].中华眼底病杂志,1998,14(1):3-6.
[21]Clarkson JG.Central vein occlusion study:photographic protocol and early natural history[J].Trans Am Ophthalmol Soc,1994,(92):203-213.