graves 病患者眼部临床表现及其伴眼球突出者血清ft3,ft4,tsh,tpoab检测的临床意义

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1、Graves病患者眼部临床表现及其伴眼球突出者血清FT3,FT4,TSH,TPOAb检测的临床意义【摘要】目的：总结分析Graves病患者出现眼球突出、眼睑退缩、眼睑闭合不全、眼睑肿胀、球结膜充血及水肿及眼球运动障碍等临床体征的分布状况;探讨FT3，FT4，TSH，TPOAb在Graves病(GD)伴眼球突出患者发病中的作用。方法：收集分析207例预行放射性碘治疗的GD患者眼部体征;采用放射免疫分析法检测125例GD伴眼球突出患者，82例GD患者血清FT3，FT4，TSH，TPOAb值，并对两组各指标的检测值进行比较。结果：患者207例发生眼球突出125例(60.4%)

2、，眼睑退缩169例(81.6%),眼睑迟落152例(73.4%),眼睑闭合不全176例(85.0%),眼睑肿胀88例(42.5%),球结膜充血及水肿92例(44.4%);眼球运动障碍者16例(7.7%),角膜水肿或溃疡3例(1.4%);两组患者间血清FT3，FT4，TSH，TPOAb值差异无显著意义(P>0.05)。结论：两组患者甲状腺均呈高分泌状态;85%以上的GD患者有不同程度的眼部表现，对于适合接受放射性碘治疗的GD患者，眼病的诊治不容忽视。【关键词】Graves眼病;眼球突出;诊断　　Abstract　　AIM:Toinvestigatethevalue

3、ofsera11FT3,FT4,TSH,TPOAbinexophthalmospatientswithGravesdisease(GD);andtosummarizeandanalyzethetopographyoftheclinicalmanifestationofGD，suchasexophthalmos,lidretractionandlidfullness,hypophasis,hyperremiaandedemaofconjunctiva,disorderofocularmovementandsoon.　　METHODS:Theclinicalmanife

4、stationsof207patientswithGDwhounderwentradioiodinetherapywerecollectedandanalyzed,andseraFT3,FT4,TSH,TPOAblevelsweremeasuredandcomparedinpatientswithGDandexophthalmos(n=125)andGDpatients(n=82).　　RESULTS:Exophthalmoswerepresentin125cases(60.4%);lidretractionin169cases(81.6%);hypophasisin

5、176cases(85.0%),lidfullnessin88cases(42.5%);hyperremiaandedemaofconjunctivain92cases(44.4%);disorderofocularmovementin16cases(7.7%);cornealedemaorulcerin3cases(1.4%);seraFT3,FT4,TSH,TPOAblevelsintwogroupshadnosignificantdifference(P>0.05).　　CONCLUSION:Bothgroupsareallinhighsecretorst

6、ate;differentocularmanifestationsarepresentinover85%11patients.Diagnosisandtreatmentofthyroidassociatedophthalmopathy(TAO)cantbeignored.　　KEYWORDS:Gravesdisease;exophthalmos;diagnose　　YiXL.ClinicalsignificanceofdeterminationofseraFT3，FT4，TSH，TPOAbinexophthalmospatientswithGravesdise

7、ase.IntJOphthalmol　　(GuojiYankeZazhi)2010;10(9):17101712　Graves眼病(Gravesophthalmopathy,GO)又被称为甲状腺相关眼病(thyroidassociatedophthalmopathy,TAO)、内分泌性眼病、自身免疫性眼眶疾病等，是Graves病(Gravesdisease，GD)最常见的甲状腺外表现，GO发病率在眼眶疾病中约占20%[1]。由于TAO发病机制不清,诊断、治疗困难,内科医生往往对TAO认识不足,只是单纯治疗甲状腺问题,未进行及时的眼