结核性葡萄膜炎临床特征、诊断策略与分级标准研究进展

doi:10.19982/j.issn.1000-6621.20250196

中国防痨杂志 ›› 2025, Vol. 47 ›› Issue (9): 1204-1211.doi: 10.19982/j.issn.1000-6621.20250196

结核性葡萄膜炎临床特征、诊断策略与分级标准研究进展

赖晓宇¹, 段鸿飞², 陈珣珣¹, 郭卉欣¹, 廖庆华¹, 陈茜³^,⁴(), 梁丹³()

¹广东省结核病控制中心门诊部,广州 510630
²首都医科大学附属北京胸科医院结核病科,北京 101100
³中山大学中山眼科中心/眼病防治全国重点实验室/广东省眼科视觉科学重点实验室/广东省眼部疾病临床医学研究中心,广州 510060
⁴中山大学附属第三医院眼科,广州 510630

收稿日期:2025-05-12 出版日期:2025-09-10 发布日期:2025-08-27
通信作者: 陈茜,梁丹 E-mail:chenqian3@mail.sysu.edu.cn;liangdan@gzzoc.com
基金资助:
广东省感染性疾病(结核病)临床医学研究中心(2020B1111170014)

Clinical characteristics, diagnostic strategies, and advances in grading criteria for tubercular uveitis

Lai Xiaoyu¹, Duan Hongfei², Chen Xunxun¹, Guo Huixin¹, Liao Qinghua¹, Chen Qian³^,⁴(), Liang Dan³()

¹Outpatient Department, Center for Tuberculosis Control of Guangdong Province, Guangzhou 510630, China
²Department of Tuberculosis, Beijing Chest Hospital, Capital Medical University, Beijing 101100, China
³Zhongshan Ophthalmic Center, Sun Yat-sen University, National Key Laboratory of Ophthalmology, Guangdong Provincial Key Laboratory of Ophthalmic Visual Science, Guangdong Clinical Research Center for Ocular Diseases, Guangzhou 510060, China
⁴Department of Ophthalmology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, China

Received:2025-05-12 Online:2025-09-10 Published:2025-08-27
Contact: Chen Qian,Liang Dan E-mail:chenqian3@mail.sysu.edu.cn;liangdan@gzzoc.com
Supported by:
Guangdong Provincial Clinical Research Center for Infectious Diseases (Tuberculosis)(2020B1111170014)

摘要/Abstract

摘要：

结核性葡萄膜炎(tubercular uveitis, TBU)是一种可独立存在的肺外结核,占全球葡萄膜炎病因的0.2%~32%,在我国约占葡萄膜炎的0.7%~4%。该病早期诊断及规范治疗可获得良好结局,但由于TBU缺乏行之有效的诊断方法,且临床表现异质性高、诊断延迟显著(平均11个月),其实际发病率可能被低估。基于此,本文从TBU的临床特征与分类、诊断标准,以及免疫学、分子生物学和病理学等诊断方法的最新进展进行系统综述,旨在为结核科、呼吸科和眼科医生提供帮助,促进TBU的早期和规范诊断。

关键词: 葡萄膜炎, 结核,眼, 疾病特征, 分子诊断技术, 综述文献(主题)

Abstract:

Tubercular uveitis (TBU) is a prevalent type of extrapulmonary tuberculosis, accounts for 0.2% to 32% of uveitis globally and approximately 0.7%-4% in China. Early diagnosis and standardized treatment of TBU can lead to favorable outcomes. However, due to the lack of reliable diagnostic methods, high clinical heterogeneity, and significant diagnostic delays (averaging 11 months), the actual incidence of TBU is likely underestimated. Hence, this article provides a systematic review of the clinical characteristics, classification, diagnostic criteria, and recent advances in immunological, molecular biological, and pathological diagnostic methods for TBU. By integrating evidence from recent studies, this article aims to assist tuberculosis specialists, pulmonologists, and ophthalmologists in promoting the early and standardized diagnosis of TBU.

Key words: Uveitis, Tuberculosis, ocular, Disease attributes, Molecular diagnostic techniques, Review literature as topic

中图分类号:

R52
R773.3

赖晓宇, 段鸿飞, 陈珣珣, 郭卉欣, 廖庆华, 陈茜, 梁丹. 结核性葡萄膜炎临床特征、诊断策略与分级标准研究进展[J]. 中国防痨杂志, 2025, 47(9): 1204-1211. doi: 10.19982/j.issn.1000-6621.20250196

Lai Xiaoyu, Duan Hongfei, Chen Xunxun, Guo Huixin, Liao Qinghua, Chen Qian, Liang Dan. Clinical characteristics, diagnostic strategies, and advances in grading criteria for tubercular uveitis[J]. Chinese Journal of Antituberculosis, 2025, 47(9): 1204-1211. doi: 10.19982/j.issn.1000-6621.20250196

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结核性葡萄膜炎临床特征、诊断策略与分级标准研究进展

Clinical characteristics, diagnostic strategies, and advances in grading criteria for tubercular uveitis

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