貝賽氏症引發葡萄膜炎之治療及護理照護

Treatment and Nursing Care of Uveitis in Behçet's Disease

彭靜尼(Ching-Ni Peng) ； 童建學(Chien-Hsueh Tung)

《醫學與健康期刊》 6卷1期 (2017/03) Pp. 97-104

摘要

貝賽氏症是一種原因不明的自體免疫疾病，約50-70%貝賽氏症會引發眼睛的葡萄膜炎，為不可逆且進行性的疾病。貝賽氏症引發之葡萄膜炎之中尤以全葡萄膜炎的發生率最高，男女比例為2.7:1，男性的好發年齡約為29歲，女性為31歲。男性的疾病進展、嚴重度及發生失明的風險高於女性，尤其在HLA-B51陽性者。發病10年後，男性與女性失明的比例為65%：35%。因此，不可忽視貝賽氏症對視力所帶來的風險。現今治療貝賽氏症所引發之葡萄膜炎的方向為口服類固醇、免疫抑制劑藥物、生物製劑注射或於晶狀體植入類固醇。開始生物製劑療程前須評估B型肝炎及肺結核的風險，而植入類固醇者則需定期檢查眼壓。本文的目的是回顧貝賽氏症引發葡萄膜炎的症狀、治療、護理照護，以及所應注意藥物引發的合併症或副作用。

關鍵字

貝賽氏症 ； 葡萄膜炎 ； 免疫抑制劑 ； 生物製劑 ； 護理照護

並列摘要

Behçet's disease is an idiopathic autoimmune disease. About 50-70% of Behçet's disease can lead to uveitis, a progressive and irreversible condition. Among the different types of Behçet uveitis, the incidence of panuveitis is the highest, with a male-to-female ratio of 2.7:1. The age of onset of Behçet uveitis is approximately 29 years old in males and 31 y.o. in females. The progression of the disease, severity, and the risk of blindness are higher in males, particularly among HLA-B51-positive Behçet's disease cases. A male-to-female ratio of blindness is 65%:35%. Therefore, the risk of visual impairment in patients with Behçet's disease cannot be overstated. Nowadays, treatment for Behçet uveitis includes the use of oral steroids, immunosuppressant drugs, biologics injection, and intravitreal steroid implants. The risk of hepatitis B and tuberculosis must be assessed before the initiation of biologics. Intraocular pressure should be monitored if intravitreal steroid implants are used. The aim of this review is to provide an overview of the symptoms, treatment, nursing care, and the drug-induced complications or side effects of Behçet uveitis.

並列關鍵字

Behçet's disease ； Uveitis ； Immunosuppression ； Biologic agents ； Nursing care

參考文獻

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