《葡萄膜病》PPT课件

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1、UvealTractDisease葡萄膜病●UvealTract葡萄膜包括:◆Iris虹膜◆Ciliarybody睫状体◆Choroid脉络膜三者彼此相连,血供系统同源.Uvitis葡萄膜炎◆Isthegenericnameoftheinflammationofuvea;retina;retinalvesselsandvitreous葡萄膜、视网膜、视网膜血管和玻璃体炎症的总称◆Alwaysinyoungpatient多见于年轻人◆Alwayscombinewithsystemicautoimmune

2、disease常合并全身自体免疫性疾病◆recurrenceisoften易复发◆Alwaysblind常致失明●Etiologyandpathogenesis病因和发病机理◆Etiology:bacteria;fungus;virus;parasiteRickettsiainfectdirectlyorbyevoketheantigen–antibodyreactionandcomplementcompoundinduceuveitisSuchasleprosy;tuberculosis;syphi

3、lis;aids.由细菌、霉菌、病毒、寄生虫、立克次体直接感染或导致抗原抗体反应和免疫复合物引起葡萄膜炎。如麻风、结核、梅毒、艾滋病◆Autoimmunity:eyeshavemanyantigen.ImmunedisorderleadtouveitissuchassympatheticuveitisStill’sdisease(juvenilerheumatoidarthritis)Harada-Vogtdisease自身免疫反应：眼有很多抗原，免疫异常导致葡萄膜炎。例如交感性眼炎、晶体过敏性眼内炎

4、、原田-小柳氏病、Behcet病等.伴发葡萄膜炎自身免疫性疾病:风湿性关节炎，系统性红斑狼疮.◆Thefunctionofmetaboliteofarachidonicacidalwaysseeninsurgery,drugandphysicalstimulation氧自由基的作用：常见于手术、外伤、以及理化刺激等导致活性氧生成过多,造成组织损害-自身氧损伤.●Classificationofuvitis分类◆classifyinetiology—infectionornon-infection病因分

5、类—感染和非感染◆classifyinpathology—granulomaornon-granulomauveitis临床病理分类—肉芽肿型和非肉芽肿型◆classifyinanatomy-1979anterior,intermediate,posteriorandpanuveitis解剖部位分—前、中、后或全葡萄膜炎(现阶段国际通用分类方法)Anterioruveitis前葡萄膜炎inChina50-60%ofuveitisareanterioruneitis我国50-60％葡萄膜炎病人是前葡萄膜

6、炎●Including3types三种类型◆acuteanterioruveitis急性前葡萄膜炎◆chronicanterioruveitis慢性前葡萄膜炎◆acuteorchronicanterioruveitis既可出现急性炎症又可出现慢性炎症的前葡萄膜炎AcuteAnteriorUveitis急性前葡萄膜炎●Clinicalfeatures临床表现◆SymptomsofanteriorUvitis症状①Achingpainintheeye剧烈眼痛②Rapidblurringofvision

7、视力急速下降③Photophobia怕光④Tearingoftheeye流泪◆Signsofanterioruveitis体症①Rednessoftheeyeciliarycongestionormixedcongestion眼球充血。睫状充血或混合性充血②KP(keratitisPrecipitate）threetypesdustlikeormediasizeorsuetlike角膜后沉着物。有三种类型：尘埃状、中等大小羊脂状KPisclumpsofwhitecellsandinfl

8、ammatorydebrisTheshapeofdistributionofKpistriangleshapeorinpupilareaofcorneaordiffusedKP:成堆白血球和炎症碎片，分布呈三角形或在瞳孔区或弥散分布③Aqueousflarethedamageofaqueousandbloodbarrierproteinexudateintoaqueouscellsandflareintheanteriorchamber---