想要攻破葡萄膜炎，首先必须了解葡萄膜炎是什么原因引起的和发病机制。
\n葡萄膜炎一般被认为是眼内炎症的总称。它包括葡萄膜、视网膜、视网膜血管和玻璃体的炎症。多发生于青壮年，常合并系统性自身免疫病，病情反复，引起严重的并发症，是常见的一类致盲眼病。
\n1．感染因素细菌、真菌、病毒、寄生虫、立克次体等可直接侵犯葡萄膜、视网膜、视网膜血管或眼内容物，引起炎症，也可诱发抗原抗体及补体复合物而引起葡萄膜炎，还可通过病原体与人体或眼组织的交叉反应（分子模拟）而引起免疫反应和炎症。感染可为内源性或外源性（手术或外伤后）。
\n2．自身免疫因素正常眼组织中含有多种致葡萄膜炎的抗原，如视网膜S抗原、光感受器间维生素A类结合蛋白、黑色素相关抗原等，在机体免疫功能紊乱时，可出现对这些抗原的免疫反应，引起葡萄膜炎。
\n3．氧化损伤机制任何原因所致氧自由基代谢产物大量增加，都可以直接导致组织损伤和葡萄膜炎，还可诱导其他炎症介质的释放，加重炎症反应。
\n4．花生四烯酸代谢产物的作用花生四烯酸在环氧酶作用下，形成前列腺素和血栓烷A2，在脂氧酶作用下形成白三烯等炎症介质，引起炎症反应。手术或外伤以及理化刺激和药物等所引起的早期炎症反应，主要与此有关。
\n5．免疫遗传机制已发现多种类型的葡萄膜炎与特定的HLA抗原相关，如关节强直性脊椎炎伴发的葡萄膜炎，与HLA-B27及亚型HLA-B2704，Vogt-小柳原田综合征与HLA-DR4、HLA-DRw53及HLA-DQA1*0301、DR4*0101、DRB1*0405和DQB1*0401等亚型；Behcet病与HLA-B5、HLA-B51等，都密切相关。
\n看上去很难懂吧，因为这里面涉及了大量的生理、生化的知识，希望这样的分析能对有关人士有一点帮助，帮助他们尽快理解这种疾病的发生、发展。
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结节病性葡萄膜炎是一种比较少见的眼科疾病，至于引起的病因在医疗上还没有明确的说法，但有免疫异常表现：T细胞功能低下，B细胞活力增强，抗体产生活跃，免疫球蛋白升高，并发现循环免疫复合物增加。组织病理表现为非干酪化肉芽肿性炎症，在巨噬细胞浆内可有嗜酸性小体。结节病性葡萄膜炎发展比较缓慢，多发生于30～40岁，女性较多。那么结节病葡萄膜炎的病理病因是什么呢，下面我就给大家介绍一下：
\n1、全身改变：最多见者是双侧肺门淋巴结肿大，早期约半数无症状但在X线片上可见改变;严重者有肺实质病变。最多见的症状有咳嗽，有少量粘痰;体重减轻，有时乏力、发烧、食欲减退;当发展为肺纤维化时有活动后的气急、发绀，也可发生咳血。其次是末梢淋巴结肿大，皮肤结节性红斑，也可侵犯神经系统、肝、脾、肾、胃肠等出现相应的各种症状。
\n2、眼部改变在眼病中以葡萄膜炎为多见：急性前葡萄膜炎。慢性前葡萄膜炎：为最多见，病程缓慢自觉症状不明显，有羊脂KP、Koeppe结节，有时虹膜有多发结节，比结核者为大，更富于血管呈粉红色;大的虹膜肉芽肿性结节易误诊为虹膜肿物。结节常自发消退或玻璃样变。严重病例发生虹膜后粘连、继发青光眼和并发性白内障。这种慢性葡萄膜炎常伴有肺纤维化。
\n3、慢性睫状体炎或周边葡萄膜炎：睫状体平坦部有渗出并可进入玻璃体和周边部视网膜;周边部小血管变细或伴白线。
\n4、脉络膜视网膜炎：眼底有灰黄色、灰白色渗出，多为圆形、略圆形，数目不一，大小不等，多位于后极部，沿血管分布，有的位于血管周围所谓蜡滴状渗出。
\n以上是对于结节病性葡萄膜炎的病理病因的介绍，这种渗出可完全吸收;但深在于色素上皮下的小渗出为肉芽肿性愈后遗留小萎缩斑。常伴有视网膜血管炎，特别是视网膜静脉周围炎是本病的特征之一。
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单纯疱疹性葡萄膜炎是葡萄膜炎的一种，单纯疱疹性葡萄膜炎的症状有很多的种类，对于单纯疱疹性葡萄膜炎这种疾病给人们带来的痛苦也是非常大的，如果得不到及时的治疗就会引起一些并发症发生，下那么在治疗之前首先就要了解这个病的病因以及发病机制，下面我就给大家介绍一下这方面的内容：
\n一、发病原因：单纯疱疹病毒有先天性和后天性感染。根据多数报道，70%新生儿HSV感染是由宫内HSV-Ⅱ型引起。由于母亲患有疱疹性子宫炎，生产时接触感染的分泌物所致。婴儿也有HSV-Ⅰ型感染是由于接触HSV-Ⅰ型感染的人员。这两种HSV型的临床和眼部表现基本相同。HSV-Ⅰ型病毒往往存在于正常人体，当机体抵抗力下降则易引起发病。其诱发因素很多如感冒、各种热病、胃肠失调等则可引起葡萄膜炎。其致病机制可以是病毒对葡萄膜的直接感染，可从患者房水中分离出病毒;也可能是对病毒的超敏反应。
\n二、发病机制：单纯疱疹病毒引起的前葡萄膜炎主要是通过病毒的直接侵犯或病毒引起的免疫应答所致，但其所致视网膜炎的确切机制尚不完全清楚。已有实验表明，病毒到达视网膜的途径至少有3个，即血源性、从眼前段蔓延和来自中枢神经系统。一般认为经血源性到达视网膜的可能性不大。有人将病毒注射至动物静脉内，并未发现眼部感染。病毒从眼前段蔓延似乎也不是进入视网膜的主要途径，这是因为在单纯疱疹病毒性前葡萄膜炎的患者中发生单纯疱疹病毒性视网膜炎的可能性并不大，单纯疱疹病毒性视网膜炎伴有的前房炎症，可能是眼前后段同时感染所致，也可能是视网膜的炎症“溢出”的结果。第3种途径即病毒从中枢神经系统到达视网膜,此可能是引起单纯疱疹病毒性视网膜炎的主要途径。众多研究已经证明，单纯疱疹病毒对神经系统尤为偏爱。
\n","barId":"1762","topicTypeId":"1","topicThemeId":"1028","readLevel":0,"files":"","clickNoLikeCount":0,"clickLikeCount":0,"clickCount":1027,"score":0,"partCount":0,"replayCount":0,"publishStatus":1,"publishTime":1486637604628,"isCream":0,"canReply":0,"shareUrl":null,"foodCouponVal":1,"emailNotice":0,"permission":0,"zlyShare":0,"status":0,"sort":0,"highlight":0,"highlightEffectTime":0,"digest":0,"digestEffectTime":0,"top":0,"topEffectTime":0,"closed":0,"stamp":0,"icon":0,"bgcolor":null,"fontcolor":null,"favtimes":0,"isAdopt":0,"adoptId":null,"sortDate":1486637604626,"metaSearch":null,"rn":0,"barTitle":null,"checkcode":null,"forumUser":{"id":"6aad1b12ea7211e6a61c00163e04584d","isDel":0,"createAt":1486168781822,"createBy":"b1a5ca4ddfad11e6a61c00163e04584d","createName":"小海螺","updateAt":0,"updateBy":null,"updateName":null,"username":"茉莉花","password":"888888","level":0,"nickName":"茉莉花","realName":null,"signName":"随遇而安","head":"http://01luntan.com/ly_img/1486169681471.jpg","phone":null,"mobile":null,"wechat":null,"qq":null,"email":null,"address":null,"identityType":1,"userType":2,"isPhoneBind":0,"status":0,"accountSource":0,"isStrangerMsg":0,"departmentId":null,"departmentName":null,"sex":2,"provinceId":"140000","cityId":"140500","userLevel":0,"modifyNameCount":1},"lyTopicReply":null,"createAtStr":null,"lyBar":null,"lyTopic":null},{"id":"4485","isDel":0,"createAt":1486637583930,"createBy":"6aad1b12ea7211e6a61c00163e04584d","createName":"茉莉花","updateAt":0,"updateBy":null,"updateName":null,"userId":"6aad1b12ea7211e6a61c00163e04584d","title":"葡萄膜炎的鉴别方法有哪些","content":"
我们的眼睛非常脆弱，所以很多眼科疾病会出现，葡萄膜炎对于大家来说有些陌生，葡萄膜炎的疾病种类分为急性和慢性两种，无论是哪一种葡萄膜炎疾病症状的发生都会对患者造成不定程度的身心伤害，一定要正确对待葡萄膜炎疾病的出现及时到有关医院进行检查治疗，那么，葡萄膜炎的鉴别方法有哪些？
\n(1)急性结膜炎呈急性发病：有异物感、烧灼感、分泌物多，检查见眼睑肿胀.结膜充血.与本病的畏光、流泪、视力模糊、睫状充血及前房炎症反应有明显不同。
\n(3)眼内肿瘤：一些原发性眼内肿瘤或转移瘤，可引起前房积脓等改变，但从病史、临床表现、超声波、CT及磁共振检查等可资鉴别。
\n(4)与能引起前葡萄膜炎的全葡萄膜炎相鉴别：一些类型的葡萄膜炎，如Behcet病、Vogt-小柳原田综合征，不但可引起前葡萄膜炎，还可引起眼后段炎症。
\n(2)急性闭角型青光眼呈急性发病：视力突然下降，头痛，恶心，呕吐，角膜上皮水肿，前房浅，房水闪辉但无炎症细胞，瞳孔呈椭圆形散大，眼压增高。与本病大量KP，前房不浅，房水炎症细胞，瞳孔缩小，叭压正常或偏低等易于鉴别
\n一旦诊断为葡萄膜炎，应积极进行治疗，散瞳是前葡萄膜炎的治疗必要措施，可防止瞳孔粘连，避免继发性青光眼和并发性白内障的产生;激素是葡萄膜炎的治疗常用药物，但有副作用，不论全身或局部用药，一定要在医生指导下使用，不宜滥用。
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任何的疾病出现的时候如果没有及早的治疗就会有危害产生，这些危害的大小就取决于疾病的病情，当眼部出现了葡萄膜炎的时候我们的生活中很多的人都不知道自己患上了葡萄膜炎那，葡萄膜炎的危害大不大?
\n葡萄膜炎的危害：
\n1、角膜水肿：这是由于炎症累及角膜内皮细胞，破坏角膜的水化作用所致。角膜带状混浊，多见于儿童的前葡萄膜炎，更多见于伴有青年类风湿性关节炎的慢性虹膜睫状体炎患者。
\n2、虹膜前、后粘连：严重者瞳孔缘全后粘连，引起瞳孔闭锁和虹膜膨隆，瞳孔区被机化膜遮盖，形成瞳孔膜闭。虹膜膨隆或前房角渗出物机化，使虹膜根部向前房角牵引可发生虹膜前粘连。以上情况都可引起继发性青光眼。
\n3、继发性青光眼：由于瞳孔闭锁，后房的房水无法经瞳孔区进入前房，引起后房压力升高，眼压急剧上升;同时也可以有虹膜周边前粘连，堵塞房角,使滤过功能减退，导致眼压升高;急性期前房水粘稠度增高，渗出物堵塞前房角，引起眼压升高。
\n4、并发性白内障：由于长期炎症刺激，影响晶体的营养及代谢，而引起晶体后囊及后皮质发生混浊。多见于慢性前葡萄膜炎和中间葡萄膜炎。
\n5、玻璃体混浊：严重的虹膜睫状体炎或后葡萄膜炎，常有玻璃体点状、条状或团块状混浊，位于玻璃体后部，随眼球转动而飘动，重者影响视力。
\n6、脉络膜脱离：为渗出性，随炎症消退而消失。
\n葡萄膜炎的治疗方法
\n西医治疗
\n葡萄膜炎的治疗，西医主要用激素，但无法根治，易于反复。根据不同的临床表现，需要采取不同的治疗措施。急性期，以热邪为主，予以清热解毒，活血化瘀。慢性期多见阴虚，肝肾不足，重在滋养肝肾，养阴清热，活血化瘀，以防复发。病情十分严重者，中西医结合治疗，全身使用皮质激素，及时有效的控制炎症。再用中药进行调整，巩固疗效，直至彻底治愈。
\n中医治疗
\n葡萄膜炎，如发生在前中部即虹膜睫状体炎，类似中医“瞳神紧小”，在后部葡萄膜(即脉络膜炎)，则归属“云雾移晴”、“视瞻昏渺”等范畴。中医药治疗该病，贵在辨证论治。
\n葡萄膜炎不妨试试中西医治疗呦。
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