Graves眼病放射治疗121例临床观察

Radiotherapy in Graves' orbitopathy--clinical analysis of 121 cases

目的分析Graves眼病放射治疗后的疗效及影响预后的因素。方法1990年～2005年121例Graves眼病患者,其中男性75例,女性46例,年龄17～68岁,中位年龄42.2岁。双眼发病者为92例,单眼发病者为29例。病程中位时间14.1个月。既往病史:糖尿病患者11例,高血压患者21例、有吸烟史的患者69例。患者接受球后放射治疗,常规分次照射,总剂量2000cGy,随访期为6个月～15年。结果照射后分别有32.2%、46.3%的患者病情明显改善和部分改善,15.7%的患者病情稳定,5.8%的患者病情进展。有软组织及角膜受累的病例放疗后症状改善最为明显(P<0.05)。结论放射治疗可有效地控制Graves眼病病情进展,并取得较好疗效,使临床症状得到改善。

Objective To study the effect of radiotherapy in Graves＂ orbitopathy and the factors influencing prognosis. Methods During 1990 to 2005,121 patients with progressive Graves＂ orbitopathy were enrolled in the study, male 75 patients and female 46 patients,aged 17 to 68 years,median age 42.2 years. Ninty-two patients with binocular Graves＂ orbitopathy and 29 patients with ocellus Graves＂ orbitopathy were enrolled. Median duration of illness was 14.1 months. All patients were received bilateral orbital irradiation 2 000 cGy in 2 weeks. The patients were following-up between 6 months and 15 years. Their response to radiation was analyzed. Results The results in patients after radiotherapy were：significant improved 32.2 % （9/121）,partial improved 46.3 %（56/121 ） ,stable symptoms 15.7 %（ 19/121 ） ,symptoms progressed 5.8 %（7/121 ）. Most significant resuhs（P 〈 0.05 ） were found in patients involved with soft tissue and cornea. Conclusion Radiotherapy could effective control the symptoms of Graves＂ orbitopathy result in better therapeutic effect and clinical manifestation improvement.