激素冲击治疗活动性格雷夫斯病眼病的疗效分析

The clinical study of the effect of steroid pulse therapy on Graves' ophthalmopathy.

目的分析影响激素冲击治疗活动性格雷夫斯病眼病(GO)疗效的因素。方法对2003年12月至2004年12月在中山大学附属第一医院内分泌科就诊的32例初诊的GO患者进行激素冲击治疗,分析治疗有效组和无效组的临床特点。结果19例(59.4%)患者治疗后眼部症状和体征有不同程度的改善。通过分级分析发现对于病程<4个月,临床活动评分(clinical activity score,CAS)>7,治疗前甲状腺刺激素抗体(TSAb)滴度高及软组织炎症症状严重的患者疗效明显优于轻度症状者。结论活动性强、病程短、治疗前TSAb高的患者接受激素冲击治疗的效果较好。

Objective To analyse the influential factors of steroid pulse therapy on Graves＇ ophthalmopathy. Methods Thirty-two newly diagnosed Graves＇ ophthalmopathy patients were treated with intravenous glucocorticoid therapy in our hospital during 2003 - 12--2004 - 12. The clinical features between favorable response patients and no response patients were compared for evaluating related factors affecting the prognoses. Results After treatment ,59.4% cases had favorable responses,and these patients had the high titer of TSAb, CAS 〉 7 and the course of GO 〈 4 months. There were no significant differences in the distribution of age and gender. Conclusion It is very essential to properly select patients and medicine operation opportunity for turnover. We think high score of CAS, short course and high level of TSAb before treatment are the indications of good prognosis.