国际放射医学核医学杂志
國際放射醫學覈醫學雜誌
국제방사의학핵의학잡지
INTERNATIONAL JOURNAL OF RADIATION MEDICINE AND NUCLEAR MEDICINE
2009年
5期
287-290
,共4页
Graves眼病%99m锝美罗酸盐%甲泼尼龙%药物疗法%老年人
Graves眼病%99m锝美囉痠鹽%甲潑尼龍%藥物療法%老年人
Graves안병%99m득미라산염%갑발니룡%약물요법%노년인
Graves ophthalmopathy%Technetium Tc 99m medronate%Methy lpredniselone%Drug therapy%Aged
目的 评价相对低剂量甲泼尼龙短程疗法联合99Tc-亚甲基二膦酸盐(99Tc-MDP)治疗老年活动性中重度Graves眼病(GO)的临床疗效及安全性.方法 24例老年活动性中重度GO患者先配对后随机分人对照组及试验组各12例.对照组应用常规大剂量甲泼尼龙间断静脉短程冲击治疗,累积剂量达800～1200 mg.试验组应用相对低剂量甲泼尼龙(累积剂量为300～480 mg)联合99Tc-MDP的治疗方案.治疗前及开始治疗后每1～4周进行定期随访观察,并根据眼病临床活动性评分及美国甲状腺协会提出的甲状腺相关眼病分度分级标准评定眼部病情变化,同时监测治疗后的不良反应.应用Ridit检验进行统计分析,比较两组疗效.结果 试验组10例患者有效,对照组6例患者有效,两组的疗效有统计学差异(t=2.121,P＜0.05).对照组的不良反应明显增多,主要体现于消化道症状,引起或加重水钠潴留与糖代谢紊乱.结论 对于老年活动性中重度GO应用相对低剂量甲泼尼龙短程疗法联合99Tc-MDP是一种临床疗效及安全性较好的治疗方案.
目的 評價相對低劑量甲潑尼龍短程療法聯閤99Tc-亞甲基二膦痠鹽(99Tc-MDP)治療老年活動性中重度Graves眼病(GO)的臨床療效及安全性.方法 24例老年活動性中重度GO患者先配對後隨機分人對照組及試驗組各12例.對照組應用常規大劑量甲潑尼龍間斷靜脈短程遲擊治療,纍積劑量達800～1200 mg.試驗組應用相對低劑量甲潑尼龍(纍積劑量為300～480 mg)聯閤99Tc-MDP的治療方案.治療前及開始治療後每1～4週進行定期隨訪觀察,併根據眼病臨床活動性評分及美國甲狀腺協會提齣的甲狀腺相關眼病分度分級標準評定眼部病情變化,同時鑑測治療後的不良反應.應用Ridit檢驗進行統計分析,比較兩組療效.結果 試驗組10例患者有效,對照組6例患者有效,兩組的療效有統計學差異(t=2.121,P＜0.05).對照組的不良反應明顯增多,主要體現于消化道癥狀,引起或加重水鈉潴留與糖代謝紊亂.結論 對于老年活動性中重度GO應用相對低劑量甲潑尼龍短程療法聯閤99Tc-MDP是一種臨床療效及安全性較好的治療方案.
목적 평개상대저제량갑발니룡단정요법연합99Tc-아갑기이련산염(99Tc-MDP)치료노년활동성중중도Graves안병(GO)적림상료효급안전성.방법 24례노년활동성중중도GO환자선배대후수궤분인대조조급시험조각12례.대조조응용상규대제량갑발니룡간단정맥단정충격치료,루적제량체800～1200 mg.시험조응용상대저제량갑발니룡(루적제량위300～480 mg)연합99Tc-MDP적치료방안.치료전급개시치료후매1～4주진행정기수방관찰,병근거안병림상활동성평분급미국갑상선협회제출적갑상선상관안병분도분급표준평정안부병정변화,동시감측치료후적불량반응.응용Ridit검험진행통계분석,비교량조료효.결과 시험조10례환자유효,대조조6례환자유효,량조적료효유통계학차이(t=2.121,P＜0.05).대조조적불량반응명현증다,주요체현우소화도증상,인기혹가중수납저류여당대사문란.결론 대우노년활동성중중도GO응용상대저제량갑발니룡단정요법연합99Tc-MDP시일충림상료효급안전성교호적치료방안.
Objective To assess the efficacy and safety of combined ~(99)Tc-methylenediphosphonate(~(99)Tc-MDP)and lower-dose methylprednisolone in the treatment of old patients with active moderate-to-severe Graves ophthalmopathy.Methods Twenty-four old patients with active moderate-to-severe Graves ophthalmopathy were randomly divided into two groups,that were methylprednisolone group(control group)and combination of ~(99)Tc-MDP and methylprednisolone group(experimental group).The two groups were similar in age,sex,duration and severity of ophthahnopathy.Patients in control group were treated with intravenous high-dose methylprednisolone pulse therapy(cumulative dose of 800～1200 mg).experimental group were treated with combination therapy of ~(99)Tc-MDP and lower-dose methylprednisolone(cumulative dose of 300～480 mg).At 12-week follow-up,therapeutic outcome was assessed by the change in clinical activity score and severity classified using Americom Thyroid Association of thyroid-associated ophthalmopathy indexing classification stcmdard.The adverse effects were observed and recorded in all patients.Results The remarkably effective outcome was observed in 6/12(50.0%)cases in control group and 10/12(83.3%)cases in experimental group.There were significant differences in the degree of improvements in ocular involvements.Less frequent and severe adverse effects were observed with the addition of ~(99)Tc-MDP to lower-dose methylprednisolone therapy.Conclusion A combination of ~(99)Tc-MDP and lower-dose methylprednisolone may be better tolerated and more effective than high-dose ophthalmopathy.
