摘要
目的探讨大剂量甲基强的松龙治疗Graves眼病的疗效。方法将入选的60例确诊为Graves病伴眼病的患者根据是否使用糖皮质激素随机分为A、B两组:A组为对照组(n=48),口服常规抗甲亢药物(丙基硫氧嘧啶、他巴唑),不使用糖皮质激素类药物;B组为治疗组(n=12),在口服常规抗甲亢药物的同时接受甲基泼尼松龙针800-1000 mg静脉滴注,每日1次,连用7-10 d;之后改为泼尼松片口服40-60 mg/d,后每半月后减量5-10 mg/d,最小剂量维持,约在半年后停药。对两组突眼度、甲状腺体积进行统计学分析。结果①突眼疗效B组明显高于A组(P<0.01);②A组治疗前、后突眼度差异无统计学意义(P>0.05);B组治疗前、后突眼度差异有统计学意义(P<0.05);B组治疗后平均突眼度减轻与A组差异有统计学意义(P<0.05);③A、B两组治疗前、后甲状腺体积均显著缩小(P<0.05);B组甲状腺体积缩小较A组差异无统计学意义(P>0.05)。结论大剂量甲基泼尼松龙静脉治疗Graves眼病安全有效。
Objective To research the efficacy of high - dose methylprednisolone therapy on Graves ophthahnopathy. Methods 80 patients with Graves disease accompanied by exophthalmos and goiters were divided into two groups randomly： group A （ n =48） served as control treated with oral antithyroid drugs only; group B （ n = 12） received high dose intravenous methylprednisolone （800 - 1000 mg/d） for 7 - 10 days and then oral prednisone （40 -60 mg/d） and then reduce the dose in a half year,together with antithyroid drugs. The degree of exophthalmos and the thyroid volumes between the two groups were compared. Results （1） The efficacy of group B was significantly better than that of group A （ P 〈 0.01 ）. （2） The degree of exophthalmos in groups A was not significant different before and after the treatment;the degree of exophthalmos in groups B was significant different before and after the treatment （ P 〈 0.05 ） ;the average decrease of exophthalmos in group B was significant difference compared with group A （ P 〈 0.05 ）. （3） The thyroid volumes of group A and B were significantly decreased after the treatment （ P 〈 0.05 ） ; and there was no difference of the thyroid volumes between group A and B. Conclusion High - dose intravenous methylprednisolone pulse therapy is effective and safe for patients with Graves ophthalmopathy.
出处
《海南医学》
CAS
2010年第4期37-39,共3页
Hainan Medical Journal
