Safety Analysis Of Hydroxychloroquinone In The Treatment Of Connective Tissue Disease In Xinjiang Area

Objective:To investigate the ocular safety of hydroxychloroquine(HCQ)in patients with connective tissue disease in Xinjiang,and to guide the clinicians to rational and standardize the use of hydroxychloroquine in order to improve their clinical application in clinical practice.Methods:(SD-OCT),visual evoked potential(VEP),and so on.The visual acuity,visual field,fundus,intraocular pressure,optical coherence tomography(SD-OCT),visual evoked potential(VEP),etc,were collected from the Department of Rheumatology in Xinjiang Autonomous Region from January 2016 to December 2016.6 eye examination were normal471 patients,requiring patients to repeat the above six months after the above check.Results:1.471 patients included 17 cases of undifferentiated connective tissue disease(UCTD),20 cases of mixed connective tissue disease(MCTD),201 cases of systemic lupus erythematosus(SLE),89 cases of Sjogren's syndrome(SS),rheumatoid arthritis RA)in 110 cases,34 cases of other connective tissue disease.Among them,39 males and 432 females aged(43.89 ±14.47)years old,the course was(5.69 ± 4.32)years.2.471 cases were divided into four groups,A1 group was not taking hydroxychloroquine,a total of 60 cases,including 4 males and 56 females,age(46.97 ± 13.72)years,duration(5.79± 2.39)years;(44.63 ± 14.31)years old,the course of disease(4.63 ± 5.31)years;A3 group taking hydroxychloroquine for the time of 0 to 0 years(including 0.5 years),a total of 90 cases,including male 7 cases,women 83 cases,age(44.63 ± 14.31)There were 238 males and 218 females with age(42.48 ± 14.99)years and duration of disease(4.16 ± 1.76)years.The time of taking hydroxychloroquine in group A4 was 5 ~ 10 years(including 5 years)(Including 10 years),a total of 83 cases,including 4 males and 79 females,aged(44.88 ±13.38)years,duration of disease(11.13 ± 5.02)years.There was no significant difference in sex and age between the four groups(P> 0.05).3.Six months again,471 patients were repeatedly examined,15 patients had abnormal eye.Among them,411 patients with hydroxychloroquine showed abnormal eye abnormality in 14 cases,including abnormal visual acuity: 7 cases of visual acuity decreased;visual field abnormalities: visual field defect in 2 cases;fundus photography abnormalities: macular pigment disorder in 8 cases;intraocular pressure abnormalities: Increased in 1 case;SD-OCT abnormalities: macular depression in 1 case;VEP abnormalities: eye amplitude decreased in 4cases.The time of ocular lesions in patients treated with hydroxychloroquine was between 0.5and 10 years(3.33 ± 2.43)and the cumulative dose of hydroxychloroquine was(482.04 ±363.4)g.Did not take hydroxychloroquine in 60 cases suffering from eye abnormalities in 1case,fundus photography abnormalities: macular pigment disorder in 1 case,several other tests no abnormalities.4.There were 59 patients with normal eyes and 1 patient with abnormal eye,the rate of ocular lesions was 1.67%.There were 88 patients with normal eye in group A2 and 2 patients with abnormal eye.The rate of ocular lesions after taking hydroxychloroquine was 2.22 % Of the normal eyes of the group of 230 patients with abnormal eye in 8 cases,taking hydroxychloroquine after the eye rate was 3.36%;A4 group of normal eye patients in 79 cases,4 cases of abnormal eye patients taking hydroxychloroquine After the eye rate was 4.81%.There was no significant difference in the rate of ocular lesions between the four groups(P>0.05).There was no significant difference in the rate of ocular lesions between the two groups(P> 0.05).5.The longest time to take hydroxychloroquine in the study was 10 years.Oral hydroxychloroquine dose was 0.4g/day.The maximum cumulative amount of hydroxychloroquine was 1460 g in 10 years and 411 patients taking hydroxychloroquine in connective tissue disease The cumulative dose of hydroxychloroquine was divided into B1 and B2 groups,B1 group <1000g,1000 g ? B2 group ? 1460 g.There were 370 patients with normal eyes,359 normal eyes and 11 eyes in the B1 group.There were 41 patients in the B2 group,38 patients with normal eyes and 3 cases of abnormal eyes.the difference between the two groups was not statistically significant(P> 0.05).6.Analysis of ocular lesions in patients taking hydroxychloroquine: 1 case of visual loss accompanied by macular pigment disorders and macular recess depression;1 case of visual field defects associated with macular pigment disorder;1 case of vision loss with macula 1case of decreased visual acuity decreased,right eye amplitude decreased,macular pigment disorder.Conclusion:1.Hydrochloroquine has good eye safety.2.With the prolongation of medication and the cumulative dose of hydroxychloroquine,the rate of disease is increasing,so it is important and necessary for patients with connective tissue disease to perform regular eye examinations during medication.3.Hydrochloroquine caused by eye lesions to more than two or more as the main performance.4.Need to further expand the sample size and extend the follow-up time to understand the safety of hydroxychloroquine long-term medication.