甲基强的松龙冲击联合球后放疗治疗中重度Graves眼病的临床研究.pdf

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1、1734GuangxiMedicalJournal，Dec．2014，f．36，No．12甲基强的松龙冲击联合球后放疗治疗中重度Graves眼病的临床研究▲黄泽锋程时武。黎南中谢纹文玉梅何燮勇王磊邵丽(1中国人民解放军总政治部机关门诊部，北京市100120，E—mail：huangzefeng5566@sina．com；2中国人民解放军第303医院内分泌科，南宁市530021)【摘要】目的观察甲基强的松龙冲击治疗联合球后放疗对中重度Graves眼病的临床疗效。方法中重度Graves眼病患者90例，根据治疗方法不同分为3组：对照组35

2、例接受抗甲状腺药物治疗；激素组32例接受甲基强的松龙冲击治疗；联合组23例接受甲基强的松龙冲击治疗和球后放疗。记录治疗前后各组患者眼球突出度、Graves眼病临床活动评分(CAS)。结果治疗过程中各组患者均未发生严重不良反应。联合组、激素组疗效明显优于对照组(P<0．05)，联合组疗效明显优于激素组(P<0．05)；治疗后3组CAS评分、眼球突出度均明显低于治疗前(P<0．05)，且下降幅度为联合组>激素组>对照组(P<0．05)。结论甲基强的松龙冲击联合球后放疗治疗中重度Graves眼病安全、有效。【关键词】Graves眼病；糖皮

3、质激素；球后放疗；甲基强的松龙【中图分类号】R581．1【文献标识码】A【文章编号】0253—4304(2014)12—1734—03DoI：1O．11675／j．issn．0253—4304．2014．12．17ClinicalStudyonMethylprednisoloneCombinedwithOrbitalRadiotherapyforTreatmentofModerate—to-severeGravesOphthalmopathyHUANGZe-feng，CHENGShi—y3U2，Nan．zhong，XIEWen2，W

4、ENYu—mei，HEXie—yong，WANGLei，SHAOLi(1Departmentof0口fnfClinic，GeneralPoliticalDepartmentofPeopleLiberationArmy，Beijing100120，China；2DepartmentofEndocrinology，No．303HospitalofPeopleSLiberationArmy，Nanning530021，China)【Abstract】ObjectiveToinvestigatetheclinicaloutcomeofmet

5、hylprednisolonecombinedwithorbitalradiotherapyforthetreatmentofmoderate—to—severeGravesophthalmopathy．MethodsNinetypatientswithmoderate—to—severeGravesophthalmopathyweredividedintothreegroupsaccordingtothetherapiestheyreceived．Thirty—fivecasesinthecontrolgroupreceiveda

6、ntithyroiddrugtherapy，32casesintheglucocorticoidgroupweretreatedwithmethylprednisolone，and23casesinthecombinationgroupweregivenmethylprednisolonepulseorbitalradiotherapy．Thedegreeofexophthalmosandclinicalactivityscore(CAS)wereobservedbeforeandaftertreatmentintwogroups．

7、Pa~sultsNoseveresideefectswereobservedinallpatientsduringtreatment．Thecombinationgroupandglucocorticoidgroupshowedbetterefectscomparedwithcontrolgroup(尸<0．05)，andthecombinationgroupshowedbettereffectscomparedwithglucocorticoidgroup(P<0．05)．ThedegreesofexophthalmosandCA

8、Sscoresaftertreatmentweresignificantlylowerthanthosebeforetreatmentinthethreegroups(P<0．05)，thedecreasewaslargestinth