The Effect of Betamethasone on Intraocular Pressure in Nephrotic Children

一九八七年七月至一九九○年六月臺北市立中興醫院有四十六名腎病症候群病兒，採用間給予Betamethasone治療，另選四十名年齡相稱正常兒作爲對照組。使用Goldmann氏壓跡式眼壓計或Schiotz氏壓跡式眼壓計測量受檢者的眼內壓，我們發現正常兒或使用藥物前病兒的眼內壓與全劑量藥物使用終了時病兒的眼內壓比較，呈有意羲的統計學差異，同時發現全劑量藥物使用終了時病兒的眼內壓與停藥後二至四週病兒的眼內壓比較也呈有意羲的統計學差異。雖然在全劑量使用Betamethas-one終了時，有六名病兒因眼內壓升高而在臨床上有頭痛或眼痛的徵狀，減量或停藥後，這些徵狀很快就消失。因此我們相信使用Betamethasone治療腎病症候群是很安全的。另一方面，由這些觀察顯示類固醇是引起眼內壓升高的一個因素，因此我們格外注意全劑量Betamethasone對眼內壓升高的變化，腎病症候群就像其他小兒疾病需長期使用類固醇治療一樣，必須定期檢查眼睛，尤其是眼內壓。

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並列摘要

Intraocular pressure (IOP) was measured by Goldmann's or Schiotz's method in 46 nephrotic children, who were treated with betamethasone, and in 40 age-matched normal controls at the Taipei Municipal Chung-Hsin Hospital, from July 1, 1987 to June 30, 1990. We found the difference in mean lop between patients treated at the end of a full-dose course of betamethasone and normal controls or patients before treatment, was statistically significant. This difference was also found between the measurement of IOP at the end of a full-dose course of betamethasone, and after stopping betamethasone therapy two to four weeks later. Although six of all patients had high IOP and suffered from headache or ocular pain, clinically, at the end of full-dose betarnethasone therapy, the symptoms disappeared quickly after tapering or stopping of the drug. Therefore, we believe it is very safe to treat the nephrotic syndrome with betamethasone. On the other hand, these observations indicate that corticosteroid is a causative factor in increasing IOP. Susceptibility to full-dose betamethasone is firmly recognized, and patients need to be monitored on an individual basis. Nephrotic syndrome is a chronic disease which often requires long-term corticosteroid treatment. Children with the syndrome are at risk of developing steroid- induced increasing IOP. Careful ophthalmological examination of nephrotic children, as well as other pediatric patients who received corticosteroid therapy, is highly recommended.

並列關鍵字

nephrotic syndrome ； intraocular pressure ； corticosteroid therpapy

國際替代計量

The Effect of Betamethasone on Intraocular Pressure in Nephrotic Children

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