摘要
目的 观察甲状腺相关眼病 (TAO)患者的临床表现以及甲状腺功能状况和抗甲状腺功能亢进 (甲亢 )治疗对TAO发生发展的影响。方法 对 1994～ 2 0 0 1年收治的 339例 (5 97只眼 )TAO患者的临床资料进行回顾性分析。结果 TAO患者多发生于 4 0岁以上的中年人 (70 5 % ) ,无明显性别差异 ;以眼球突出和复视为主要就诊原因 ,70 %以上的患者有眼征和眼外肌受累 ;339例患者中 ,甲状腺功能正常者 93例 ;甲状腺功能异常 (甲亢或甲低 )者 2 4 6例。甲状腺功能异常者中TAOⅤ、Ⅵ级患者明显多于甲状腺功能正常者。13 1I抗甲亢治疗后有 39 3%患者发生了眼病 ,口服抗甲亢药物有15 6 %患者发生了眼病 ,而行甲状腺次全切除术后有 14 0 %患者发生眼病 ,所有患者眼部病变均出现在甲亢控制以后 ,大多数患者是由于发生了甲状腺功能低下。结论 甲状腺功能状况与TAO病变的严重程度有一定相关性 ;快速而过度的抗甲亢治疗可能对TAO产生不利影响 ;及时适当的治疗可提高治疗效果。
Objective To summarize the clinical manifestation of thyroid-associated ophthalmopathy (TAO), to analyze the thyroid function and to monitor the therapeutic effect of anti-hyperthyroidism on the progression of TAO. Methods Three hundred and thirty nine TAO cases (597 eyes) were collected from 1994 to 2001 and their clinical manifestations were summarize and analyzed. Results TAO occurred mostly in individuals over 40 years with no gender preference. Exophthalmos and diplopia were the major manifestations and main reasons for ophthalmic examination. Retraction of eyelids and involvement of extraocular muscle were present in over 70% cases. In 339 TAO cases, euthyroidsm was found in 93 cases and abnormal thyroid function (hyperthyroidism or hypothyroidism) was present in 246 cases. The V and VI grade of TAO occurred more frequently in patients with abnormal thyroid function than those with euthyroidism. 131 I, oral anti-hyperthyroidism drug, or thyroidectomy was used for all patients with abnormal thyroid function. TAO occurred in 39.3% cases treated with 131 I, in 15.6% cases with oral anti-hyperthyroidism drug, and in 14% cases with thyroidectomy. All ocular pathologic changes occurred after hyperthyroidism had been controlled and hypothyroidism was found in most of these cases. Conclusions The condition of thyroid function has a certain relationship to the severity of TAO. Over-fast and undue anti-hyperthyroidism therapy may impact an untoward effect on TAO;immediate and appropriate treatment can improve the effect of therapy on TAO.
出处
《中华眼科杂志》
CAS
CSCD
北大核心
2004年第6期368-372,共5页
Chinese Journal of Ophthalmology
