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目的分析和探讨真性红细胞增多症患者眼部病变的临床特征。方法对6例以眼部症状为首发表现的真性红细胞增多症病人,常规行裂隙灯、眼底镜及眼底荧光血管造影检查并用血细胞分离机行红细胞清除术。对其中1例在血象正常后行2期人工晶体植入术。结果6例患者全身及眼部症状明显缓解,眼底静脉血管迂曲状态有所缓解,视盘边界较前清晰,其中1例伴有上睑下垂的患者眼睑下垂症状明显改善,1例无晶体眼行人工晶体植入术后玻璃体出血,经对症处理后出血吸收。结论真性红细胞增多症在眼部的临床表现缺乏特异性。凡出现眼部症状伴异常血象特别是红细胞异常增多者,应怀疑真性红细胞增多症的可能。利用血细胞分离机行红细胞清除术是治疗真性红细胞增多症合并眼部病变的有效措施。
Objective To analyze and explore the clinical features of ocular lesions in patients with polycythemia vera. Methods Six cases of polycythemia vera with ocular symptoms as the first manifestation were routinely examined by slit lamp, ophthalmoscope and fundus fluorescein angiography. Erythrocyte debridement was performed by blood cell separator. One of them was performed 2 cases of IOL implantation after blood normal. Results The symptoms of the whole body and the eye were relieved in 6 patients. The tortuous state of fundus veins was eased and the border of the optic disc was clear. The eyelid ptosis symptom was significantly improved in 1 patient with ptosis and 1 patient without cristobal eye After vitrectomy vitreous hemorrhage, after symptomatic treatment of bleeding absorption. Conclusion The clinical manifestations of polycythemia vera lack specificity. Where there are abnormal ocular symptoms with abnormal blood erythrocyte abnormalities, especially those who should be suspected true polycythemia may be. The use of hematocrit erythrocyte debridement is an effective treatment for polycythemia complicated with ocular lesions.