慢性脏疾病中的冠状腺和视网膜透性变化 - - 文献综述
Giacomo De Rosa1, Francesco Paolo De Rosa1, Giovanni Ottonelli1
1Department of Biomedical Sciences, Humanitas University, Via Rita Levi, Montalcini 4, 20072 Pieve Emanuele, MI, Italy.
Journal of clinical medicine
|December 30, 2025
概括
慢性病 (CKD) 和其治疗方法会破坏眼液平衡,增加血清性视网膜脱落和中央血清性胆色素变异的风险. 早期的眼科查和合作是管理这些危及视力的条件的关键.
科学领域:
- 眼科和科的眼科和科.
- 视网膜和胸腔血管生理学
- 系统性疾病对眼睛健康的影响
背景情况:
- 慢性病 (CKD),特别是末期病 (ESKD),影响系统性液体平衡.
- 眼液平衡与系统参数 (如眼膜压力和水静力) 密切相关.
- 以前的研究表明,病与特定的视网膜病理之间存在潜在联系.
研究的目的:
- 审查和综合证据,关于如何CKD及其治疗影响冠状腺和视网膜的血管透性.
- 调查由此产生的眼内液平衡的变化,特别关注ESKD.
- 确定与CKD患者眼部疾病相关的风险因素和临床结果.
主要方法:
- 关于 MEDLINE 的综合文献搜索,参考列表和专业文本 (1980-2025).
- 包括144篇文章:临床试验,观察队列和病例报告.
- 数据抽象侧重于胸膜厚度,血视网膜屏障完整性,CSCR/SRD发生率和系统因素 (性压力,高血压,皮质类固醇,RPE功能).
主要成果:
- ESKD会造成低性压力,波动的水静力和受损的RPE功能,导致下液的三位一体.
- 血液透析急性降低了亚叶胆道厚度,但对视网膜厚度有不一致的影响.
- 透析患者的SRD (3-4倍) 和CSCR (1.5倍) 风险显著增加,腹腔透析带来最大风险. 移植后的CSCR患病率约为6%,与手术,高血压和免疫抑制剂有关.
结论:
- 系统性流体压力失衡和CKD治疗严重破坏了外层血视网膜屏障.
- 定期的眼科监测和早期症状查对于检测眼部并发症至关重要.
- 密切的科医生-眼科医生合作对于及时管理慢性病患者的视力威胁状况至关重要.
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