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目的观察颅内静脉窦血栓形成(CVST)患者的眼部临床特征。方法回顾分析数字减影血管造影检查确诊的CVST住院患者118例的临床资料,其中男性53例,女性65例,男女之比为1∶1.2,首发年龄最小者为15岁,最大为67岁,多见于20~45岁。根据患者的不同起病方式分为急性起病(2d以内)、亚急性起病(2d~1个月)、慢性起病(超过1个月)3组,分析其眼部及全身表现特点与相关检查的相互关系。其中58患者在确诊和治疗后进行了1年左右的随访观察。结果118例CVST患者中以眼部症状为首发表现者25例,占21.2%;眼部症状与其它症状同时发生者36例,占30.5%。非眼部症状首发者57例,占48.3%。各组之间首发症状差别无显著的统计学意义。最常见的眼部症状为视物模糊和视力下降(61只眼),占以眼部异常为主诉者的85.9%。最常见的眼部体征为视盘水肿(57只眼),占本组患者的48.3%。58例随诊患者中,13例患者因视神经萎缩而出现视力严重减退,占随访者的22.4%。眼部表现均与CVST引起的颅内高压有关。结论CVST患者中约1/3的患者有眼部症状;1/5的患者以眼部症状为首发表现。视力下降、视盘水肿是其常见的表现。对于不明原因的颅内压增高的患者应该警惕CVST。
Objective To observe the clinical features of the eye in patients with intracranial venous sinus thrombosis (CVST). Methods The clinical data of 118 inpatients with CVST confirmed by digital subtraction angiography were retrospectively analyzed. There were 53 males and 65 females, the ratio of male to female was 1: 1.2. The minimum age at onset was 15 years and the maximum was 67 years. More common in 20 to 45 years old. According to the patients’ different modes of onset, they were divided into three groups: acute onset (within 2 days), subacute onset (2d ~ 1 month), chronic onset (over 1 month), and their ocular and systemic manifestations The correlation between the relevant inspection. 58 patients were diagnosed and treated for about 1 year follow-up observation. Results Among the 118 patients with CVST, 25 cases (21.2%) had first onset of eye symptoms and 36 (30.5%) had ocular symptoms and other symptoms simultaneously. 57 cases of non-eye symptoms first episode, accounting for 48.3%. No significant difference in the first symptom between the groups was statistically significant. The most common ocular symptoms were blurred vision and decreased visual acuity (61 eyes), accounting for 85.9% of those with eye abnormalities. The most common ocular signs were optic disc edema (57 eyes), accounting for 48.3% of patients in this group. Of the 58 patients who were followed up, 13 patients developed severe vision loss due to optic atrophy, accounting for 22.4% of the respondents. Ocular manifestations were associated with CVST-induced intracranial hypertension. Conclusions About one-third of patients with CVST have ocular symptoms; one-fifth of patients have ocular symptoms as the first manifestation. Visual acuity, optic disc edema is a common manifestation. CVST should be warned in patients with unexplained increase in intracranial pressure.