论文部分内容阅读
作者报告的一例系患冠状动脉功能不全经长期服用冠心宁(Perhexiline maleate)而引起的视乳头水肿,合并有末梢多发性的神经根病变。患者男性,46岁,主诉双眼视力下降、头痛,有右注视位时的一时性的水平复视。眼科检查:视力:右4/10,左6/10。眼底检查发现有双眼视乳头水肿。视野检查有双眼生理盲点扩大并有鼻侧视野缺损。既往史:三年前起,因心绞痛,每日按300mg量,坚持服用冠心宁。其他临床检查:脑电图、颅脑X光摄片、颅脑断层测量(tomodensimetrie)和右侧颈内动脉造影均属正常,大脑同位素扫描和左侧颈动脉血管造影显示有左侧横窦发育不全。脑压:150mm水柱。化验:有脑脊液的蛋白-细胞分离现象:第一次蛋白质1.68g/L,其中γ-球蛋白为8％;第二次(二个月后)蛋白质1.20g/L。SGOT:70。SGPT:386。病人就诊后,一直在皮质素药物(SYNACTHENE)的治疗下,初时曾一度视力明显好转(右7/10,左9/10),视野恢复正常,但双眼视乳头
The authors report a case of optic papilla edema caused by long-term use of Perhexiline maleate, which is associated with coronary insufficiency, and is associated with peripheral multiple root lesions. Male, 46 years old, complains of binocular vision loss, headache, temporary diplopia with right eye position. Eye examination: visual acuity: right 4/10, left 6/10. Fundus examination found that binocular papilledema. Visual field examination with binocular physiological blind spots to expand and have nasal visual field defects. Past history: Three years ago, due to angina, daily dose of 300mg, insisted on taking Guanxin Ning. Other clinical tests: EEG, brain X-ray, tomodensimetrie and right internal carotid artery angiography were normal, cerebral isotope scan and left carotid angiography showed left transverse sinus development Incomplete. Brain pressure: 150mm water column. Laboratory: Cerebrospinal fluid protein - cell separation Phenomenon: the first protein 1.68g / L, of which γ-globulin was 8%; the second (after two months) protein 1.20g / L. SGOT: 70. SGPT: 386. After treatment, the patient was treated with SYNACTHENE for the first time, with obvious improvement of visual acuity (right 7/10, left 9/10), visual field returned to normal, but the binocular optic nerve