糖皮质激素对Graves眼病和Th1／Th2细胞因子的影响

The effect of steroids on proptosis and Th1/Th2 cytokines in Graves ophthaimopathy

目的探讨糖皮质激素对Graves眼病（GO）突眼的疗效以及对Th1／Th2细胞因子的影响。方法45例GO分为4组：B组抗甲状腺药物治疗；C组同时口服强的松；D组：C组＋球后注射地塞米松；E组：C组＋甲状腺注射地塞米松和奥曲肽。结果GO患者血清Th1和Th2细胞因子明显升高，糖皮质激素治疗后下降，C组突眼的疗效为63．6％，D组和E组有效率分别为78．6％和80％。结论糖皮质激素对突眼的疗效是肯定的，可能是通过调节细胞因子的水平而发挥作用，球后或甲状腺注射能提高疗效。

Objective To investigate the effect of steroids on proptosis and Th1/Th2 cytokines in Graves ophthalmopathy （GO）. Methods 45 patients with GO were divided into four groups randomly, group B with anti - thyroid drugs, group C with anti - thyroid drugs and steroids, group D based on group C and additional retrobulbar injection with steroids, group E based on group C and additional intrathyroid injection with steroids. The levels of serum IFN-r,IL-2,IL-4,IL-10 were measured. Results The levels of IFN-r,IL-2,IL-4 and IL-10 were increased in patients with GO, but were reduced after treated with steroids. The efficacy of group C treated with steroids on proptosis was 63. 6%, group D with additional retrobulbar injection and E with additional intrathyroid injection were 78. 6% and 80% respectively. Conclusion The efficacy of steroids on proptosis is valid. Additional retrobulbar injection or intrathyroid injection can improve its efficacy.