【摘要】  　　目的 探讨糖皮质激素性青光眼的病因、临床特点、治疗方法和预防措施。方法 对４７例（９１眼）糖皮质激素性青光眼患者进行回顾性分析。结果 ４７例中，男性３０例，女性１７例，年龄１２～５７岁，均为局部使用糖皮质激素。所有患者均具有开角型青光眼的临床表现。７３眼（８０.２２％）伴有特征性的后囊膜下白内障。７４眼（８１.３２％）停用糖皮质激素类滴眼液后眼压降至正常，６眼（６.５９％）用抗青光眼药物后眼压控制，１５眼（１６.４８％）经停用糖皮质激素类滴眼液、降眼压处理后眼压控制不良，手术治疗。结论 滥用药物是发生糖皮质激素性青光眼的重要原因。治疗应根据患者的用药时间、视盘和视功能损害程度及眼压的控制程度采取相应措施，强调合理用药。

【关键词】  糖皮质激素；开角型青光眼；临床分析

　　［Ａｂｓｔｒａｃｔ］ Ｏｂｊｅｃｔｉｖｅ  To investigate the etiology, clinical characteristics, treatment and prevention of glucocorticoid induced glaucoma (GIG). Methods Forty-seven cases (91 eyes) with GIG, including 30 males and 17 females in the age range of 12～57 years, were studied retrospectively. Results All patiently used local glucocorticoid. Conjunctivitis from various causes was the main reason for using glucocorticoid. All cases had clinical features very similar to primary open-angle glaucoma. There were 73 eyes (80.22％) with characteristic posterior subcapsular cataract. The intraocular pressure (IOP) of 74 eyes (81.32%) was controlled without GC drops. Six eyes (6.59%) were controlled with anti-glaucoma medicine. Surgery was chosen to treat IOP in 15 eyes (16.48%) that could not be controlled with anti-glaucoma medication. Conclusion  The important factor that leads to GIG is the abuse of glucocorticoid. Proper treatment should be based on the following factors: the duration of medication, the degree of the damage to the optic disc, visual function, and the level of IOP control. In conclusion, appropriate prescriptions can reduce the incidence of introgentic ophthalmocace.

    ［Ｋｅｙ ｗｏｒｄｓ］  gｌｕｃｏｃｏｒｔｉｃｏｉｄ； ｏｐｅｎ－ａｎｇｌｅ ｇｌａｕｃｏｍａ；clinical

　　糖皮质激素性青光眼（ｇｌｕｃｏｃｏｒｔｉｃｏｉｄ ｉｎｄｕｃｅｄ ｇｌａｕｃｏｍａ， ＧＩＧ）是由于局部或全身应用糖皮质激素（ｇｌｕｃｏｃｏｒｔｉｃｏｉｄ， ＧＣ）后引起的一种继发性开角型青光眼。多年来对于糖皮质激素性青光眼的研究有许多报道，但仍没引起足够重视，不少患者由于原发病症状的掩盖，或无症状的慢性高眼压等多种原因，没得到及时的诊断和治疗，造成视功能损害，甚至失明。现总结我院２００１年３月至２００４年１２月门诊及病房诊治的４７例（９１眼）糖皮质激素性青光眼，旨在引起临床医师注意，报告如下。

    １  资料和方法

    １.１  一般资料  本组ＧＩＧ患者４７例９１眼，其中，男性３０例５７眼，女性１７例３４眼，年龄１２～５７岁。所有患者均因结膜炎、眼部不适或其他眼病，由医生给药或患者自购ＧＣ滴眼液，其中以患者自购居多。

    １.２  临床分型  ?譹?訛糖皮质激素性青光眼：局部长期应用ＧＣ，具有青光眼性视神经损害，其损害程度与用药剂量及时间成正比，可伴有或不伴有后囊下混浊，停药后眼压恢复正常并长期维持稳定。?譺?訛糖皮质激素性青光眼残余期：基本情况同ＧＩＧ，但停药后眼压不能恢复正常，需用降眼压药物维持或手术治疗［１］。

    １.３  方法  每例患者均详细记录使用ＧＣ滴眼剂的原因、药品名称、获得药品的方式、用药量和用药时间。所有患者均进行裂隙灯显微镜眼前段检查、眼压测量（Ｔｏｐｃｏｎ非接触眼压计）、前房角镜检查、散瞳检查晶状体和周边视网膜、视野检查。

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