【摘要】  　　目的：观察老年人糖尿病性眼肌麻痹的临床表现及治疗效果，并探讨其发病机制。方法：对20例眼肌麻痹的老年患者行常规眼科检查和眼肌功能检查，并进行全身及血生化检查确诊为糖尿病后，给予降血糖、对伴高血压者控制血压，同时肌注维生素B1、B12并口服血管扩张剂和小剂量皮质类固醇。结果：所有患者治疗6~12wk后眼球运动正常，复视消失，随访6~8mo，有2例分别在3mo和5mo时复发。 结论：老年人糖尿病性眼肌麻痹的主要表现为复视及上睑下垂，经控制血糖及其它对症支持治疗后，眼肌麻痹均能治愈，但有少数患者在治愈后复发。

【关键词】  糖尿病　眼肌麻痹　老年人

　　Clinical observation of ophthalmoplegia in the aged with diabetes

    Da-Li Kuang, Zhong-Gui Yin

    Department of Ophthalmology, Peoples Hospital of Pudong New District, Shanghai 201200, China

    Abstract AIM:To observe clinical situation and therapeutic efficacy of ophthalmoplegia in the aged with diabetes, and to discuss its pathogenetic mechanism.  METHODS: In addition to routine ophthalmologic examination and ocular muscle examination, general check-up and blood biochemical examination were also included. Twenty cases of ophthalmoplegia with diabetes were treated with vitamin B1 and B12 and prednisone and drugs of vascular dilatation, meanwhile concentration of blood sugar and hypertension in which were also controlled.  RESULTS: After 20 cases had been treated for 6~12 weeks, their ocular movement became normal and the diplopia disappeared, 2 cases of which recurred during follow-up 6~8 months.  CONCLUSION: Main manifestations of ophthalmoplegia in the aged with diabetes are diplopia and blepharoptosis, ophthalmoplegia can be cured by drugs, but a few of which will recur.

    · KEYWORDS: diabetes; ophthalmoplegia; the aged

　　0引言

    糖尿病是一种以糖代谢紊乱为主要表现的内分泌疾病，此类患者并发眼肌麻痹的情况临床上较少见，我们总结1997-03/2005-08在门诊治疗的老年人糖尿病性眼肌麻痹患者20例，现报告如下。

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