环孢霉素A联合糖皮质激素治疗复发性HLA―B27相关性前葡萄膜炎的【摘要】目的探?环孢霉素A联合糖皮质激素治疗复发性人类白细胞抗原-B27（HLA-B27）相关性前葡萄膜炎的临床疗效。方法28例（35眼）复发性HLA-B27相关性前葡萄膜炎患者，随机分为对照组和研究组，每组14例（研究组18眼，对照组17眼）。对照组给予糖皮质激素治疗，研究组给予环孢霉素A联合糖皮质激素治疗。比较两组患者治疗前后视力变化情况、前房炎症细胞改善情况、治疗显效时间、复发情况及不良反应发生情况。结果研究组视力治疗总有效率为94.44%，对照组视力治疗总有效率为94.12%，比较差异无统计学意义（P>0.05）。治疗后3个月，两组患者的前房炎症细胞均较本组治疗前改善，差异均具有统计学意义（P<0.05）；治疗后组间比较，差异无统计学意义（P>0.05）。研究组患者治疗显效时间优于对照组，差异具有统计学意义（P<0.05）；研究组复发率0低于对照组25.00%，差异具有统计学意义（χ2=4.836，P<0.05）。研究组不良反应发生率为14.29%，与对照组的14.29%比较，差异无统计学意义（P>0.05）。结论环孢霉素A联合糖皮质激素治疗复发性HLA-B27相关性前葡萄膜炎与单纯糖皮质激素治疗具有同样显著的疗效，且不良反应少，但联合使用环孢霉素A后能缩短病程、减少复发率，值得临床应用。【关键词】环孢霉素A；糖皮质激素；复发性；HLA-B27相关性前葡萄膜炎DOI：10.14163/jki.11-5547/r.2017.13.004【Abstract】ObjectiveToexploretheclinicalcurativeeffectofcyclosporineAcombinedwithglucocorticoidinthetreatmentofrecurrenthumanleucocyteantigen-B27（HLA-B27）relatedanterioruveitis.MethodsAtotalof28recurrentHLA-B27relatedanterioruveitispatients（35eyes）wererandomlydividedintocontrolgroupandresearchgroup，with14casesineachgroup（18eyesinresearchgroupand17eyesincontrolgroup）.Thecontrolgroupreceivedglucocorticoidfortreatment，andtheresearchgroupreceivedcyclosporineAcombinedwithglucocorticoidfortreatmentparisonweremadeonvisionchanges，anteriorchamberinflammationcellsimprovementsituationbeforeandaftertreatment，treatmenteffectivetime，relapseandadversereactionsoccurrencesituationintwogroups.ResultsTheresearchgrouphadtotaleffectiverateofvisiontreatmentas94.44%，whichwas94.12%inthecontrolgroup，andthedifferencehadnostatisticalsignificance（P>0.05）.After3monthsoftreatment，bothgroupshadimprovedanteriorchamberinflammationcellsthanthatbeforetreatment，andthedifferencehadstatisticalsignificance（P<0.05）.Bothgroupshadnostatisticallysignificantdifferenceintwogroupsaftertreatment（P>0.05）.Theresearchgrouphadbettertreatmenteffectivetimethanthecontrolgroup，andthedifferencehadstatisticalsignificance（P<0.05）.Theresearchgrouphadlowerrecurrencerateas0than25.00%inthecontrolgroup，andthedifferencehadstatisticalsignificance（χ2=4.836，P<0.05）.Theresearchgrouphadnostatisticallysignificantdifferenceinincidenceofadversereactionsas14.29%，comparingwith14.29%inthecontrolgroup（P>0.05）.ConclusionCombinationofcyclosporineAandglucocorticoidshowsequalsignificantcurativeeffect，comparingwithsimpleglucocorticoidinthetreatmentofrecurrentHLA-B27relatedanterioruveitis，andtheyallhavelessadversereactions，butcombinedwithcyclosporineAcanshortendurationofsymptomsandreducetherecurrencerate.Soitisworthyofclinicalapplication.【Keywords】CyclosporineA；Glucocorticoid；Recurrent；HLA-B27relatedanterioruveitis葡萄膜炎是一类常见的致盲眼病，受到国际范围内广泛的关注。前葡萄膜炎是葡萄膜炎最常见的种类，发病率占所有葡萄膜炎的50%～92%[1]。前葡萄膜炎病因和类型多种多样，HLA-B27相关性前葡萄膜炎是其中之一，发病率占前葡萄膜炎的40%～70%[2-4]，其发病年龄更早，起病更急，症状常重于...