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1、UvealTractDisease葡萄膜病●UvealTract葡萄膜包括:◆Iris虹膜◆Ciliarybody睫狀體◆Choroid脈絡膜三者彼此相連,血供系統(tǒng)同源.Uvitis葡萄膜炎◆Isthegenericnameoftheinflammationofuvea;retina;retinalvesselsandvitreous葡萄膜、視網(wǎng)膜、視網(wǎng)膜血管和玻璃體炎癥的總稱◆Alwaysinyoungpatient多見于年輕人◆Alwayscombinewithsystemicautoimmune
2、disease常合并全身自體免疫性疾病◆recurrenceisoften易復發(fā)◆Alwaysblind常致失明●Etiologyandpathogenesis病因和發(fā)病機理◆Etiology:bacteria;fungus;virus;parasiteRickettsiainfectdirectlyorbyevoketheantigen–antibodyreactionandcomplementcompoundinduceuveitisSuchasleprosy;tuberculosis;syphi
3、lis;aids.由細菌、霉菌、病毒、寄生蟲、立克次體直接感染或?qū)е驴乖贵w反應和免疫復合物引起葡萄膜炎。如麻風、結核、梅毒、艾滋病◆Autoimmunity:eyeshavemanyantigen.ImmunedisorderleadtouveitissuchassympatheticuveitisStill’sdisease(juvenilerheumatoidarthritis)Harada-Vogtdisease自身免疫反應：眼有很多抗原，免疫異常導致葡萄膜炎。例如交感性眼炎、晶體過敏性眼內(nèi)炎
4、、原田-小柳氏病、Behcet病等.伴發(fā)葡萄膜炎自身免疫性疾病:風濕性關節(jié)炎，系統(tǒng)性紅斑狼瘡.◆Thefunctionofmetaboliteofarachidonicacidalwaysseeninsurgery,drugandphysicalstimulation氧自由基的作用：常見于手術、外傷、以及理化刺激等導致活性氧生成過多,造成組織損害-自身氧損傷.●Classificationofuvitis分類◆classifyinetiology—infectionornon-infection病因分
5、類—感染和非感染◆classifyinpathology—granulomaornon-granulomauveitis臨床病理分類—肉芽腫型和非肉芽腫型◆classifyinanatomy-1979anterior,intermediate,posteriorandpanuveitis解剖部位分—前、中、后或全葡萄膜炎(現(xiàn)階段國際通用分類方法)Anterioruveitis前葡萄膜炎inChina50-60%ofuveitisareanterioruneitis我國50-60％葡萄膜炎病人是前葡萄膜
6、炎●Including3types三種類型◆acuteanterioruveitis急性前葡萄膜炎◆chronicanterioruveitis慢性前葡萄膜炎◆acuteorchronicanterioruveitis既可出現(xiàn)急性炎癥又可出現(xiàn)慢性炎癥的前葡萄 膜炎AcuteAnteriorUveitis急性前葡萄膜炎●Clinicalfeatures臨床表現(xiàn)◆SymptomsofanteriorUvitis癥狀①Achingpainintheeye劇烈眼痛 ②Rapidblurringofvision
7、視力急速下降 ③Photophobia怕光 ④Tearingoftheeye流淚◆Signsofanterioruveitis體癥 ①Rednessoftheeyeciliarycongestionormixedcongestion眼球充血。睫狀充血或混合 性充血②KP(keratitisPrecipitate）threetypes dustlikeormedia sizeorsuetlike角膜后沉著物。 有三種類型：塵埃狀、中等大小 羊脂狀KPisclumpsofwhitecellsandinfl
8、ammatorydebrisTheshapeofdistributionofKpistriangleshapeorin pupilareaofcorneaordiffused KP:成堆白血球和炎癥碎片，分布呈三角形或在瞳孔區(qū)或彌散分布③Aqueousflarethedamage ofaqueousandbloodbarrier proteinexudateintoaqueous cellsandflareintheanterior chamber---
