糖皮质激素单药及联合环磷酰胺治疗甲状腺相关眼病的临床研究

Clinical research of single glucocorticoid treatment and glucocorticoid joint cydophosphamide treatment on thyroid-associated ophthalmopathy

目的研究糖皮质激素单药及联合环磷酰胺治疗甲状腺相关眼病的疗效。方法回顾性分析应用单纯糖皮质激素（单药组，甲泼尼龙）的35例患者和糖皮质激素联合环磷酰胺（联合组，泼尼松＋环磷酰胺）治疗的16例患者的临床资料。结果联合组总有效率（93．8％）显著高于单药组（68．6％）（X^2=3．87，P〈0．05）。单纯应用糖皮质激素对CAS评分、突眼度、软组织炎症评分均有显著治疗效果，但疗效显著低于联合组（P〈0．05）。两组不良反应发生率差异无统计学意义。结论联合糖皮质激素和环磷酰胺较单纯应用糖皮质激素，对甲状腺相关眼病的疗效更好，不良反应更低，尤其适合对激素治疗无效或效果不佳的患者。

Objective To explore the effect of single glucocorticoid treatment and glucocorticoid joint cyclo- phosphamide treatment on thyroid-associated ophthalmopathy. Methods Retrospective analysis of clinical data of 35 patients used single glucocorticoid（ single medicine group） and 16 patients used glucocorticoids joint cyclophospha- mide（joint group） was carried out. Results The effective rate of joint group（93.8% ） was significantly higher than single drug group（68.6% ）（X^2 =3.87,P 〈0.05）. Simple using glucocorticoid had significant treatment effect at CAS score, prominent eyes degrees, soft tissue inflammation score, but the curative effect was significantly lower than the joint group （ P 〈 0. 05 ）. The adverse reaction rate had no significant difference between two groups. Conclusion Compared to single glucocorticoid treatment, the glucocorticoid joint cyclophosphamide treatment had better effect and lower adverse reaction rate, especially suitable for patients who had no effect or low effect on hormone therapy.