摘要
目的:观察应用球后放射治疗结合不同给药途径的糖皮质激素联合治疗75例甲状腺眼病的疗效。方法:采用随机、对照、前瞻性研究,比较口服糖皮质激素和脉冲静注糖皮质激素治疗Graves'眼病的比较研究。结果:突眼、眼裂宽度在应用不同的治疗手段后,都有明显的缓解,与治疗前比较差异有显著性(P<0.001)。复视在静注糖皮质激素治疗组有31例(81.5%),共有19例(61.3%)在治疗后有明显的疗效;口服糖皮质激素组有29例(78.3%),共有12例(41.3%)在治疗后有明显的疗效,两组间差异有显著性。两组病例经过治疗后,临床活动积分均明显下降,与治疗前对比差异有显著性,静注糖皮质激素治疗组临床活动积分下降更明显,与口服糖皮质激素组对比差异有显著性;但值得关注的是库欣氏征,在口服糖皮质激素组(15例,40.5%)明显高于静注糖皮质激素组(5例,18.4%),二者有明显差异。结论:大剂量脉冲糖皮质激素联合球后放疗治疗Graves'眼病比口服糖皮质激素有更好的疗效,而副作用相对较少,患者更易耐受。
Objective To observe the effectiveness and tolerability of orbital radiotherapy combined with oral or iv glucocorticoids for the treatment of severe Graves' Ophthalmopathy. Methods Seventy- five consecutive patients with active Graves' ophthalmopathy and hyperthroidism were treated, in a prospective, comparative, randomized study, with oral or iv glucocorticoids. Results Proptosis、 lid width is significant redution in the two groups(P< 0. 001),with no difference between the two groups. Diplopia significantly improved in tobh groups:19 patients(78. 3% )in iv glucocorticoid patients and 12 cases(41. 3% ) in oral glucocorticoid group. The digree of amelioration of diplopia has significantly differed between the two groups. The Clinical Activity Score was significantly lower in iv glucocorticoid than in oral glucocorticoid group(P< 0. 01). Cushingoid features developed in 5 of iv glucocorticoid patients and 15 of oral glucocorticoid patients(P< 0. 01). Conclusions High- dose iv glucocorticoid are more effective in the management of severe Graves' ophthalmopathy and was better tolerated, fewer side effects than oral glucocorticoid treatment.
出处
《实用医学杂志》
CAS
2005年第11期1135-1137,共3页
The Journal of Practical Medicine
