| Objective:1)To analyze the characteristics of KF ring in patients with HLD by using slit lamp,so as to provide objective basis for early diagnosis of this disease.2)To study the relationship between KF ring grade and age,course of disease,clinical classification,TCM syndrome type,ceruloplasmin,serum copper,24-hour urine copper,liver fibrosis and brain damage location in patients with HLD,so as to provide guidance and basis for clinical diagnosis and treatment and disease observation.Methods:1)The clinical data of HLD patients who met the inclusion criteria were collected,and the clinical data were recorded:name,sex,age,course of disease,western medicine classification,TCM syndrome type,serum ceruloplasmin,serum copper,24-hour urine copper,liver fibrosis,craniocerebral MRI damage site.Slit lamp examination was performed on each patient,and the results were recorded according to the KF ring classification standard.2)SPSS24.0 was used for statistical processing,measurement data were expressed by mean±standard deviation(x±S),multiple groups of data with normal distribution and uniform variance were tested by single factor ANOVA test,and data of non-normal distribution were tested by nonparametric test;counting data were described by percentage,and chi-square test was used for comparison between groups;nonparametric test and Spearman correlation should be used for grade data comparison.Picture drawing with using Graph Pad Prism V8.0 software.Results:1)Among the 320 patients with HLD,there were 70 cases(21.9%)of grade0,49 cases(15.3%)of grade 1,75 cases(23.4%)of grade 2,73 cases(22.8%)of grade 3 and 53 cases(16.6%)of grade 4 in the KF ring classification of HLD patients.2)Among the 320 patients with HLD,there were 189 males(59.1%)and131 females(40.9%).By chi-square analysis,there was no statistical significance in KF ring between male and female(P>0.05).3)Among the 320 patients with HLD,the age of onset ranged from 2 years and 6 months to 49 years.In different age groups,the positive rates of KF ring?5 years old,6?9 years old,10?19 years old,20?29 years old and?30 years old were 0%,51.4%,86.8%,88.5%and 91.7%,respectively.The positive rate of KF ring in patients aged 6?9 years,10?19 years,20?29years and?30 years was significantly higher than that in patients aged?5years(X~2=16.65,60.72,79.95,54.30,P<0.01),the positive rate of KF ring in patients aged 10?19 years,20?29 years and?30 years was significantly higher than that in patients aged 6?9 years(X2=17.50,25.02,17.70,P<0.05).Spearmam correlation analysis showed that the grade correlation coefficient of KF ring classification and age stratification r_s=0.480,P<0.01,indicating that there was a significant correlation between age stratification and KF ring classification.4)The duration of disease in HLD patients ranged from 8 days to 22 years.The positive rates of KF ring in different duration groups?3 months,4?6months,7?12 months,13months?3 years and>3 year groups were:22.2%,60.7%,55.3%,88.3%and 95.6%,respectively.Among the groups with different disease courses,the positive rate of KF ring in the groups with disease course of 4?6 months,7?12 months,13months?3 years and>3year was higher than that with disease course?3 months(X~2=9.80,8.47,42.45,106.68,P<0.05).The positive rate of corneal k-f ring in 13 months to 3years and>3 years was higher than that in 4 to 6 months(X~2=8.95,33.06,P<0.05).Spearman correlation analysis:KF ring classification and the correlation coefficient between KF ring classification and disease duration rs=0.601,P<0.01,indicating that there was a significant correlation between corneal k-f ring classification and disease duration.5)In the clinical classification of western medicine,the positive rates of KF ring in patients with liver type,brain type,mixed type and other types were 53.0%,96.8%,96.6%and 66.7%,respectively.The positive rate of KF ring in patients with cerebral type and mixed type was higher than that of patients with hepatic type(X~2=63.94,34.17,P<0.05),and the positive rate of k-f ring in patients with cerebral type and mixed type was higher than that of patients with hepatic type(X~2=11.784,P<0.05).6)In TCM syndrome differentiation,the positive rates of KF ring in dampness-heat type,phlegm-stasis type,spleen-kidney yang deficiency type,liver-qi stagnation type and liver-kidney yin deficiency type were84.5%,74.2%,66.7%,70.4%and 76.9%respectively.There were statistically significant differences in the positive rates of phlegm-blood stasis pattern,spleen-kidney Yang deficiency pattern and KF ring(X~2=3.90,6.09,P<0.05).Kruskal-wallis test suggested that there was no significant difference in corneal k-f ring classification among different TCM clinical classifications(P>0.05).7)There was no correlation between ceruloplasmin,serum copper,24-hour urinary copper,hyaluronic acid,N-terminal peptide of type III procollagen,laminin and Krape F ring of type IV collagen cornea(P>0.05).8)Among the 320 patients with HLD,12 had not undergone craniocerebral MRI examination,and 31 had no abnormalities.The main lesions of the brain were located in the shell nucleus in 194(60.6%),cauda nucleus in129(40.3%)and thalamus in 123(38.4%).The positive rate of corneal k-f ring in pallidus,caudatus,thalamus,putamen and brain atrophy was higher than that in patients without brain abnormalities(X~2=30.712,27.219,55.130,31.035,39.902,P<0.05).Kruskal-wallis test suggested that the corneal k-f ring grading was statistically significant(X~2=89.38,P<0.05).Paired comparison of KF ring grading in the lesion site of encephalopathy revealed that there were no abnormal-putamen,no abnormal-caudate nucleus,no abnormal-pallidum,no abnormal-brain atrophy,no abnormal-thalamus,no abnormal-brain atrophy.There were significant differences among the above 7 groups(P<0.05).Conclusion:1)There was a positive correlation between corneal KF ring and time factors such as age and course of disease in patients with HLD,but it was common for patients with age?5 years and course of disease?3 months to be negative.2)In the clinical classification of western medicine,the brain type and mixed type are more likely to have corneal KF ring;in the TCM classification,the type of dampness and heat is easy to appear corneal KF.3)There is a wide range of brain damage in HLD,and there is a certain correlation between the grade of corneal KF ring and the location of craniocerebral lesions. |
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