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目的 评估地塞米松植入剂对梅毒性后葡萄膜炎的临床效果，并初步分析其潜在作用机制。方法 选取2020年1月至2025年6月南京中医药大学附属南京医院眼科收治的40例梅毒性后葡萄膜炎患者，采用随机分配方式分为对照组20例(30只眼)与研究组20例(30只眼)。对照组实施规范驱梅治疗；研究组在驱梅治疗同时联合玻璃体腔注射地塞米松植入剂。两组疗程结束后2周，观察并比较两组治疗前后的最佳矫正视力、眼压、眼底影像学表现、光学相干断层扫描(OCT)参数以及房水白细胞介素-6(IL-6)浓度变化。结果 治疗后，研究组总有效率为90.0%,显著高于对照组的60.0%(P<0.01)。两组视力均较治疗前改善，且研究组视力提升幅度大于对照组(P<0.01)。两组房水IL-6浓度与黄斑中心厚度(CMT)在治疗后均下降，研究组下降程度较对照组更为明显(P<0.01)。结论 地塞米松植入剂联合驱梅治疗能够明显改善梅毒性后葡萄膜炎患者视力，减轻黄斑区水肿，降低房水中IL-6水平。
Abstract：[1] WU S R,YE F,WANG Y F,et al.Neurosyphilis:Insights into its Pathogenesis,Susceptibility,Diagnosis,Treatment,and Prevention[J].Front Neurol,2023,14:1340321.
[2] CHEN Y C,LIN C P,YANG C H,et al.Diagnosis and Treatment of Syphilitic Uveitis:Taiwan Experts Consensus[J].J Chin Med Assoc,2024,87(7):659—663.
[3] SHIELDS M K,ARANTES E,LAKE S R,et al.Influence of Gender on Clinical Presentation,Management Practices and Outcomes of Ocular Syphilis[J].Sci Rep,2024,14(1):16390.
[4] NAGPAL M,MEHROTRA N,JUNEJA R,et al.Dexamethasone Implant (0.7 mg) in Indian Patients with Macular Edema:Real-life Scenario[J].Taiwan Journal of Ophthalmology,2018,8(3):141—148.
[5] WENG C Y,ALBINI T A.Syphilitic Posterior Uveitis[J].JAMA Ophthalmol,2015,133(4):144630 .
[6] ROOS K L.Neurosyphilis in Musicians and Composers[J].Semin Neurol,1999,19(Suppl 1):35—40.
[7] DAVIS J L.Ocular Syphilis[J].Curr Opin Ophthalmol,2014,25(6):513—518.
[8] SHEN J,FENG L,LI Y.Ocular Syphilis:An Alarming Infectious Eye Disease[J].I nt J Clin Exp Med,2015,8(5):7770—7777.
[9] 顾莉莉，高凡，王彦荣，等.糖皮质激素在梅毒性葡萄膜炎治疗中的使用时机[J].国际眼科杂志，2025,25(7):1177—1181.
[10] PEREZ V,PAPALIODIS G,CHU D,et al.Elevated Levels of Interleukin 6 in the Vitreous Fluid of Patients with Pars Planitis and Posterior Uveitis:The Massachusetts Eye & Ear Experience and Review of Previous Studies[J].Ocul Immunol Inflamm,2004,12(3):205—214.
[11] AMADI-OBI A,YU C R,LIU X,et al.TH17 Cells Contribute to Uveitis and Scleritis and are Expanded by IL-2 and Inhibited by IL-27/STAT1[J].Nat Med,2007,13(6):711—718.
[12] OHTA K,WIGGERT B,YAMAGAMI S,et al.Analysis of Immunomodulatory Activities of Aqueous Humor from Eyes of Mice with Experimental Autoimmune Uveitis[J].J Immunol,2019,164(3):1185—1192.
[13] 赵紫楠，吕俊玲，田超，等.地塞米松玻璃体内植入剂治疗继发黄斑水肿安全性与有效性的Meta分析[J].中国药学杂志，2020,55(8):643—649.
[14] VAN DER WIJK ANNE-EVA,CANNING PAUL,VAN HEIJNINGEN RUTGER P,et al.Glucocorticoids Exert Differential Effects on the Endothelium in an in Vitro Model of the Blood-retinal Barrier[J] .Acta Ophthalmol,2019,97(2):214—224.
[15] WANG K,WANG Y,GAO L,et al.Dexamethasone Inhibits Leukocyte Accumulation and Vascular Permeability in Retina of Streptozotocin-induced Diabetic Rats Via Reducing Vascular Endothelial Growth Factor and Intercellular Adhesion Molecule-1 Expression[J].Biol Pharm Bull,2008,31(8):1541—1546.
[16] NAGPAL M,MEHROTRA N,JUNEJA R,et al.Dexamethasone Implant (0.7 mg) in Indian Patients with Macular Edema:Real-life Scenario[J].Taiwan Journal of Ophthalmology,2018,8(3):141—148.
基本信息:
DOI：10.16096/J.cnki.nmgyxzz.2026.58.03.012
中图分类号:R759.1;R773
引用信息:
[1]张芳玲,潘天鸿,洪瑾,等.地塞米松植入剂治疗梅毒性后葡萄膜炎的临床分析[J].内蒙古医学杂志,2026,58(03):325-328.DOI:10.16096/J.cnki.nmgyxzz.2026.58.03.012.
基金信息:
国家自然科学基金资助项目(编号：81300323)
2026-01-26
2026
2026-02-26
2026
1
2026-03-31
2026-03-31