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BMJ：角膜两旁的结膜发生皱褶，还有三角形白斑——啥病啊？

2016-12-07 MedSci MedSci原创

Bitot斑维生素A
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患者男性，35岁，酗酒，发现自身左眼出现异常而就诊（图1）。检查患者的视力并没有问题，也没有表现出营养不良或胃肠道疾病的迹象。但是其左眼睑裂部角膜缘的两侧球结膜出现三角形斑（Bitot斑）。血清维生素A的水平为0.27µmol/L（参考范围0.70-3.50µmol/L）。Bitot斑的发现提示着着维生素A缺乏，且是杯状细胞减少，革兰氏阳性杆菌积累和结膜上皮角质化的病理学表现。给予患者全身应用维生

患者男性，35岁，酗酒，发现自身左眼出现异常而就诊（图1）。



检查患者的视力并没有问题，也没有表现出营养不良或胃肠道疾病的迹象。但是其左眼睑裂部角膜缘的两侧球结膜出现三角形斑（Bitot斑）。血清维生素A的水平为0.27µmol/L（参考范围0.70-3.50µmol/L）。

Bitot斑的发现提示着着维生素A缺乏，且是杯状细胞减少，革兰氏阳性杆菌积累和结膜上皮角质化的病理学表现。

给予患者全身应用维生素A后大部分患者的Bitot斑可消失，但是约1/4的患者可能对治疗反应并不完全。本病例患者接受口服维生素A（第1, 2和 14天200 000 IU）治疗随访1个月时发现患者开始多治疗有反应，且在治疗3个月后Bitot斑消失。

原始出处：

Koushik Tripathy, Yog Raj Sharma. Bitot’s spot. BMJ.07 December 2016.


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    2017-11-15 gaoxiaoe

    #BMJ#

    0

  2. [GetPortalCommentsPageByObjectIdResponse(id=1848187, encodeId=d798184818e56, content=<a href='/topic/show?id=2977356edc' target=_blank style='color:#2F92EE;'>#BMJ#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3567, encryptionId=2977356edc, topicName=BMJ)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=148754, createdName=gaoxiaoe, createdTime=Wed Nov 15 13:44:00 CST 2017, time=2017-11-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=161705, encodeId=5df6161e0520, content=维生素A缺乏的角结膜软化症, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://q.qlogo.cn/qqapp/101296147/259E5ED39E0D4282FD78CD856729A447/100, createdBy=494c1710017, createdName=阿寿6126f9b9, createdTime=Sat Dec 10 12:20:10 CST 2016, time=2016-12-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1349062, encodeId=9c8b134906244, content=<a href='/topic/show?id=4337909284a' target=_blank style='color:#2F92EE;'>#角膜#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=90928, encryptionId=4337909284a, topicName=角膜)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=568152, createdName=snowpeakxu, createdTime=Fri Dec 09 13:44:00 CST 2016, time=2016-12-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=161165, encodeId=ac5816116523, content=不知道是什么病？！, beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=92191944782, createdName=thlabcde, createdTime=Thu Dec 08 10:56:43 CST 2016, time=2016-12-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=161146, encodeId=63fc16114636, content=和酗酒有关系吗, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=90f31612316, createdName=xiaotaiyang1, createdTime=Thu Dec 08 09:53:29 CST 2016, time=2016-12-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=161104, encodeId=322216110483, content=所以它是什么, beContent=null, objectType=article, channel=null, level=null, likeNumber=3, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLBkyaelI9ia3n9SbuKmBdaY0PqCOzd0nhRUstroXmUmXZ5EBTmibtLEvCCIpyHAqxQXGfZz49ibrwjkg/0, createdBy=39781652829, createdName=雾夜芭蕾, createdTime=Thu Dec 08 07:27:02 CST 2016, time=2016-12-08, status=1, ipAttribution=)]
    2016-12-10 阿寿6126f9b9

    维生素A缺乏的角结膜软化症

    0

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    2016-12-09 snowpeakxu

    #角膜#

    0

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    2016-12-08 thlabcde

    不知道是什么病？！

    0

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    2016-12-08 xiaotaiyang1

    和酗酒有关系吗

    0

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    2016-12-08 雾夜芭蕾

    所以它是什么

    0