乙胺丁醇致视神经损害临床分析

摘要

目的 探讨乙胺丁醇中毒性视神经病变的影响因素.方法 选取2012年1月至2013年12月北京老年医院眼科就诊患者56例,对其服用乙胺丁醇致视神经病变的各种影响因素进行回顾性分析.结果 将年龄作为控制变量,结果显示日剂量与患者服药至视功能损害时间呈负相关[日剂量分别为0.75、1.00、1.25 g,服药至视功能损害时间分别为(179±53)、(148±47)、(114±19)d,r=-0.283,P＜0.05].不同日剂量组患者就诊时视力差异有统计学意义[日剂量分别为0.75、1.00、1.25 g,就诊时视力分别为(0.61±0.25)、(0.39±0.18)、(0.27 ±0.13),F=5.762,P＜0.01].同样,控制年龄变量,等级相关分析结果显示日剂量与视野损害发生率呈正相关(r =0.871,P＜0.01),与色觉损害发生率也呈正相关(r=0.842,P＜0.01).将年龄与服药剂量作为控制变量,探讨糖尿病患者的视功能损害情况.56例患者中17例合并糖尿病,39例未合并糖尿病.合并糖尿病与未合并糖尿病患者就诊时视力差异无统计学意义[就诊时视力分别为(0.56±0.24)、(0.35±0.18),F=2.442,P＞0.05].与视野及色觉的等级相关分析结果显示,是否患糖尿病与视野损害发生率呈正相关(r =0.327,P＜0.05),与色觉损害发生率也呈正相关(r=0.605,P＜0.01).结论 乙胺丁醇日剂量高和合并糖尿病是乙胺丁醇致视神经损害的危险因素.%Objective To investigate the risk factors of optic neuropathy by ethambutol toxicity.Methods Fifty-six patients of optic neuropathy by ethambutol toxicity were analyzed to explore potential risk factors.All cases were enrolled in ophthalnology department,Beijing geriatric hospital,from January 2012 to December 2013.Results Daily dosage was significantly associated with the duration to visual impairment[daily doses were 0.75 g,1.00 g,1.25 g,the time of taking medicine to visual function damage were (179 ± 53) d,(148 ± 47) d,(114± 19) d,r =-0.283,P ＜ 0.05].Significant difference between different daily dosage groups was found regarding visual acuity [treatment of vision were (0.61 ± 0.25),(0.39 ± 0.18),(0.27 ± 0.13),F =5.762,P ＜ 0.01].After adjusted age with rank correlation analysis,daily dosage was significantly associated with the impairment of visual field (r =0.871,P ＜0.01) and color vision (r =0.842,P ＜0.01).Visual function of diabetic retinopathy patients was investigated with age and daily dosage adjusted in analysis.No difference for visual acuity was detected between the two groups [treatment of vision were (0.56 ± 0.24),(0.35 ± 0.18),F =2.442,P ＞ 0.05].Rank correlation analysis showed that diabetes was significantly associated with the impairment of visual field (r=0.327,P＜0.05) and color vision (r=0.605,P＜0.01).Conclusion High daily dose and presence of diabetes are risk factors for optic neuropathy by ethambutol toxicity.