摘要目的 评价大剂量激素冲击治疗急性期VKH综合征的早期疗效与安全性.方法 回顾性病例研究.收集2013年6月至2017年1月在上海市徐汇区中心医院治疗的急性期VKH综合征患者,依据有无渗出性视网膜脱离分高剂量组与低剂量组,并分别采用初始剂量为1.0g/dt和0.5g/d的甲基泼尼松龙冲击,观察视力改善情况、药物毒副反应等.结果 共纳入101例(200只眼)患者,平均就诊时间(18.57±13.83)d.16例(15.84％)伴有头痛耳鸣等症状,但均在激素冲击2d后缓解.大剂量激素冲击后200只眼视力平均提高(4.51±2.90)行.3只眼(1.50％)视力下降1行.有渗出性视网膜脱离(高剂量组)的患者治疗后视力提高行数与无渗出性视网膜脱离(低剂量组)患者相当,但其中1例(0.99％)出现药物性肝功能异常.101例患者均无激素性青光眼等眼部和全身其他并发症.结论 急性期VKH综合征采用大剂量甲基泼尼松龙冲击治疗安全性高,早期治疗效果良好.

abstractsObjective To evaluate the early efficacy and safety of high doses Methylprednisolone in the treatment of acute Vogt-Koyanagi-Harada syndrome (VKH syndrome).Methods Retrospective cases study.The patients with acute VKH syndrome treated in our hospital from June 2013 to January 2017 were collected.According to the presence of exudative retinal detachment or not,patients were dosed with methylprednisolone 1.0 g per day or 0.5 g per day initially.The improvement of visual acutity and side effects of drugs were observed.Results 101 patients(200 eyes) were enrolled.The average treatment time was(18.57±13.83) days.16 cases (15.84％) had headache and tinnitus,which were relieved two days after methylprednisolone impulse intravenous therapy.At the end of impulse therapy,the average visual acuity of 200 eyes was increased (4.51± 2.90) lines,3 eyes(1.50％) decreased 1 lines.Compared to the cases with no exudative retinal detachment,patients with exudative retinal detachment had the same visual acuity improvement but 1 cases (0.99％) occurred drug-induced liver dysfunction.Glucocorticoid induced glaucoma or other ocular and systemic complications were not observed.Conclusions The treatment of acute VKH syndrome with large dose of methylprednisolone is effective and safe.