CAJ | 학술논문

目的观察中重度甲状腺相关眼病糖皮质激素静脉治疗或联合眼眶放疗短期临床疗效及不良反应.方法回顾性分析2000年1月1日至2014年4月1日在解放军总医院住院治疗的83例中重度甲状腺相关眼病患者资料.其中进行单纯激素静脉冲击治疗(IVGC) 36例(IVGC组),激素冲击联合眼眶局部放疗(IVGC+ OR)47例(IVGC+ OR组),对患者眼部软组织充血、水肿、眼球突出、复视以及总体疗效和不良反应等进行治疗前后及组间比较.结果治疗后患者短期内眼部临床活动性评分(GAS)、眼球突出、复视等均得到改善(均P＜0.05),组间比较CAS变化、突眼、复视缓解情况差异均无统计学意义(均P＞0.05),IVGC组总体有效率50.0％(18/36),IVGC+ OR组总体有效率63.8％(30/47),两组比较差异无统计学意义(P＞0.05).结论糖皮质激素静脉冲击治疗甲状腺相关眼病短期可得到改善,短期内联合放疗疗效与单纯激素冲击治疗效果相近,严格入选患者可避免严重不良反应.
목적 관찰중중도갑상선상관안병당피질격소정맥치료혹연합안광방료단기림상료효급불량반응.방법 회고성분석2000년1월1일지2014년4월1일재해방군총의원주원치료적83례중중도갑상선상관안병환자자료.기중진행단순격소정맥충격치료(IVGC) 36례(IVGC조),격소충격연합안광국부방료(IVGC+ OR)47례(IVGC+ OR조),대환자안부연조직충혈、수종、안구돌출、복시이급총체료효화불량반응등진행치료전후급조간비교.결과 치료후환자단기내안부림상활동성평분(GAS)、안구돌출、복시등균득도개선(균P＜0.05),조간비교CAS변화、돌안、복시완해정황차이균무통계학의의(균P＞0.05),IVGC조총체유효솔50.0％(18/36),IVGC+ OR조총체유효솔63.8％(30/47),량조비교차이무통계학의의(P＞0.05).결론 당피질격소정맥충격치료갑상선상관안병단기가득도개선,단기내연합방료료효여단순격소충격치료효과상근,엄격입선환자가피면엄중불량반응.
Objective To evaluate the outcomes of intravenous glucocorticoid therapy with or without orbital radiotherapy for moderate-to-severe Graves' ophthalmopathy.Methods A total of 83 patients with moderate-to-severe Graves' ophthalmopathy were retrospectively analyzed.Intravenous glucocorticoid was given to patients for 3 consecutive days every four weeks in 1-3 circles.The regimens included intravenous glucocorticoid alone (n =36) and intravenous glucocorticoid plus orbital radiotherapy (n =47).Photophobia,lacrimation,eye pain,soft tissue congestion,edema,exophthalmos and diplopia were compared before and after treatment.The symptoms and efficacies were compared between two groups.Results During a 12-week follow-up,clinical activity score (CAS),exophthalmos and diplopia all improved after treatment (P ＜ 0.05).However,the changes of CAS,exophthalmos or diplopia showed no inter-group differences (P ＞ 0.05).The overall clinical response was 50％ in glucocorticoid group and 63.8％ in glucocorticoid plus orbital radiotherapy group.And there was no statistical difference (P ＞ 0.05).Conclusion Moderate-to-severe Graves' ophthalmopathy may be relieved by pulsed intravenous glucocorticoid with or without orbital radiotherapy.There is no inter-group difference in short-term efficacies.