• 四川大學(xué)華西第四醫(yī)院眼科（成都，610072）;2四川省醫(yī)學(xué)科學(xué)院·四川省人民醫(yī)院眼科;

目的 　比較更昔洛韋聯(lián)合甲潑尼龍綜合療法和甲潑尼龍綜合療法治療病毒性視神經(jīng)炎的療效。 方法 　將2008年10月－2010年3月入院41例（60只眼）病毒抗體檢測(cè)陽(yáng)性的病毒性視神經(jīng)炎患者隨機(jī)分為治療組，21例30只眼）和對(duì)照組（20例30只眼）。于治療前和治療第3、7、14、30、90、180天觀察兩組患者的視力、視野。 結(jié)果 　兩組患者的視力、平均視野缺損治療組采用更昔洛韋聯(lián)合甲潑尼龍綜合療法，對(duì)照組采用甲潑尼龍綜合療法。均隨時(shí)間得到改善（P＜0.001）。兩組患者視力在治療的第3天開始恢復(fù)，30 d治療組視力明顯優(yōu)于對(duì)照組（P＜0.05），治療180 d時(shí)兩組視力改善無(wú)差異（P＞0.05）；治療組與對(duì)照組分別在第7天和第14天平均視野缺損開始恢復(fù)（P＜0.001）。 結(jié)論　 更昔洛韋聯(lián)合甲潑尼龍綜合療法較單純甲潑尼龍綜合療法治療病毒性視神經(jīng)炎能更快提高患者視力、恢復(fù)視野、改善患者視覺質(zhì)量。

引用本文： 李迎春,樊映川,胡建斌,陳豫川,劉婭莉,李宇. 更昔洛韋聯(lián)合甲潑尼龍治療病毒性視神經(jīng)炎. 華西醫(yī)學(xué), 2012, 27(7): 1054-1056. doi: 復(fù)制

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2. 　陳貽言.甲潑尼松龍聯(lián)合施普善治療急性視神經(jīng)炎療效觀察[J].國(guó)際眼科雜志, 2004, 4(3): 576-577.
3. 　Martin C, EnbomM, SoderstromM, et al. Absence of seven human herpesviruses,including HHV-6, by polymerase chain reaction in CSF and blood from patients with multiple sclerosis and optic neuritis[J]. Acta Neurol Scand, 1997, 95（5）: 280-283.
4. 　Corssmit EP, Leverstein-van Hall MA, Portegies P, et al. Severe neurological complications in association with Epstein-Barr virus infection[J]. Neurovirol, 1997, 3（6）: 460-464.
5. 　蔡莉, 王雨生, 胡丹. 視神經(jīng)炎98例病因?qū)W臨床分析[J]. 國(guó)際眼科雜志, 2007, 7(3): 734-735.
6. 　韋企平, 孫艷紅, 宮曉紅, 等. 兒童視神經(jīng)炎83例的病因和預(yù)后[J].國(guó)際眼科雜志, 2005, 5(1): 123-125.
7. 　Roelandt V, Fayol L, Hugonenq C, et al. Retrobulbar optic nerritis and chicken pox: a case report in a child[J]. Arch Pediatr, 2005, 12(3): 278-280.
8. 　Pless ML. Malik SI. Relapsing-remitting, corticosteroid-sensitive, varicella zoster virus optic neuritis[J]. Pediatric Neurology, 2003， 29(5): 422-424.
9. 　Mechai F, Boutolleau D, Manceron V, et al. Human herpesvirus 6-associated retrobulbar optic neuritis in an HIV-infected patient: response to anti-herpesvirus therapy and long-term outcome[J]. Medical Virol, 2007, 79(7): 931-934.
10. 　de Almeida JR, Al Khabori M, Guyatt GH, et al. Combined corticosteroid and antiviral treatment for Bell palsy: a systematic review and meta-analysis[J]. JAMA, 2009, 302(9): 985-993.
11. 　Beck RW, Cleary PA, Anderson MM, et al. A randomized controlled trial of corticosteroids in the treatment of acute optic neuritis[J]. N Engl J Med, 1992, 326(9): 581-588.
12. 　Nikoskelainen E, Salmi A, Nikoskelainen J, et al. Virus antibody levels in serumandcerebros pinalfluids pecimens from patients with optic neuritis[J]. Acta Neurol Scand, 1977, 63(Suppl): 193-198.
13. 　Martin C, Enbom M, Soderstrom M, et al. Absence of seven humanher pesviruses,including HHV-6, by polymerase chain reaction in CSF and blood from patients with multiple sclerosis and optic neuritis[J]. Acta Neurol Scand, 1997, 95(5): 280-283.
14. 　藍(lán)育青, 張馳, 夏朝霞, 等. 急性視神經(jīng)炎的臨床特征和療效分析[J]. 國(guó)際眼科雜志, 2008, 8(9): 1935-1937.
15. 　Potter NT, Bigazzi PE. Acute optic neuritis associated with immunization with the CNS myelin proteolipid protein[J]. Invest Ophthalmol Vis Sci , 1992, 33: 1717-1722.
16. 　嚴(yán)密. 關(guān)于視神經(jīng)炎治療的新概念[J]. 中華眼底病雜志, 2000, 16(2): 129.
17. 　de Almeida JR, Al Khabori M, Guyatt GH, et al. Combined corticosteroid and antiviral treatment for Bell palsy: a systematic review and meta-analysis[J]. JAMA, 2009, 302(9): 985-993.
18. 　金義翠. 新一代抗病毒藥物法昔洛韋[J]. 廣州醫(yī)藥, 2002, 33(6): 6.
19. 　姜宏, 李保院, 韓業(yè)坤, 等. 更昔洛韋的臨床應(yīng)用進(jìn)展 [J]. 齊魯藥事, 2006, 25(3): 166-168.
  1. 1. 　BeckRW, Probe JD. What we have 1earned from the optic neuritis treatment trail[J]. Ophthalmology, 1995, 102(10): 1504-1508.
  2. 2. 　陳貽言.甲潑尼松龍聯(lián)合施普善治療急性視神經(jīng)炎療效觀察[J].國(guó)際眼科雜志, 2004, 4(3): 576-577.
  3. 3. 　Martin C, EnbomM, SoderstromM, et al. Absence of seven human herpesviruses,including HHV-6, by polymerase chain reaction in CSF and blood from patients with multiple sclerosis and optic neuritis[J]. Acta Neurol Scand, 1997, 95（5）: 280-283.
  4. 4. 　Corssmit EP, Leverstein-van Hall MA, Portegies P, et al. Severe neurological complications in association with Epstein-Barr virus infection[J]. Neurovirol, 1997, 3（6）: 460-464.
  5. 5. 　蔡莉, 王雨生, 胡丹. 視神經(jīng)炎98例病因?qū)W臨床分析[J]. 國(guó)際眼科雜志, 2007, 7(3): 734-735.
  6. 6. 　韋企平, 孫艷紅, 宮曉紅, 等. 兒童視神經(jīng)炎83例的病因和預(yù)后[J].國(guó)際眼科雜志, 2005, 5(1): 123-125.
  7. 7. 　Roelandt V, Fayol L, Hugonenq C, et al. Retrobulbar optic nerritis and chicken pox: a case report in a child[J]. Arch Pediatr, 2005, 12(3): 278-280.
  8. 8. 　Pless ML. Malik SI. Relapsing-remitting, corticosteroid-sensitive, varicella zoster virus optic neuritis[J]. Pediatric Neurology, 2003， 29(5): 422-424.
  9. 9. 　Mechai F, Boutolleau D, Manceron V, et al. Human herpesvirus 6-associated retrobulbar optic neuritis in an HIV-infected patient: response to anti-herpesvirus therapy and long-term outcome[J]. Medical Virol, 2007, 79(7): 931-934.
  10. 10. 　de Almeida JR, Al Khabori M, Guyatt GH, et al. Combined corticosteroid and antiviral treatment for Bell palsy: a systematic review and meta-analysis[J]. JAMA, 2009, 302(9): 985-993.
  11. 11. 　Beck RW, Cleary PA, Anderson MM, et al. A randomized controlled trial of corticosteroids in the treatment of acute optic neuritis[J]. N Engl J Med, 1992, 326(9): 581-588.
  12. 12. 　Nikoskelainen E, Salmi A, Nikoskelainen J, et al. Virus antibody levels in serumandcerebros pinalfluids pecimens from patients with optic neuritis[J]. Acta Neurol Scand, 1977, 63(Suppl): 193-198.
  13. 13. 　Martin C, Enbom M, Soderstrom M, et al. Absence of seven humanher pesviruses,including HHV-6, by polymerase chain reaction in CSF and blood from patients with multiple sclerosis and optic neuritis[J]. Acta Neurol Scand, 1997, 95(5): 280-283.
  14. 14. 　藍(lán)育青, 張馳, 夏朝霞, 等. 急性視神經(jīng)炎的臨床特征和療效分析[J]. 國(guó)際眼科雜志, 2008, 8(9): 1935-1937.
  15. 15. 　Potter NT, Bigazzi PE. Acute optic neuritis associated with immunization with the CNS myelin proteolipid protein[J]. Invest Ophthalmol Vis Sci , 1992, 33: 1717-1722.
  16. 16. 　嚴(yán)密. 關(guān)于視神經(jīng)炎治療的新概念[J]. 中華眼底病雜志, 2000, 16(2): 129.
  17. 17. 　de Almeida JR, Al Khabori M, Guyatt GH, et al. Combined corticosteroid and antiviral treatment for Bell palsy: a systematic review and meta-analysis[J]. JAMA, 2009, 302(9): 985-993.
  18. 18. 　金義翠. 新一代抗病毒藥物法昔洛韋[J]. 廣州醫(yī)藥, 2002, 33(6): 6.
  19. 19. 　姜宏, 李保院, 韓業(yè)坤, 等. 更昔洛韋的臨床應(yīng)用進(jìn)展 [J]. 齊魯藥事, 2006, 25(3): 166-168.