Graves病眼型和眼型Graves病临床分析比较

Clinical analysis of Graves' opthalmopathy and ophthalmic Graves' disease.

目的比较分析Graves病眼型和眼型Graves病的不同临床特点,以供临床诊断。方法对69例Graves病眼型和38例眼型Graves病病例资料进行了临床分析。结果发现两者具有特征性眼症,眼睑退缩,上睑下落退缓,眼球前突症状。Graves病眼型患者自觉症状明显,且多双眼患病,双眼球突出,病程较长,而眼型Graves病患者多为青状年,约半数无任何自觉症状,且单眼患病多见,主要为单眼球突出。实验室检查眼型Graves病患者三碘甲状腺原氨酸(T3)、甲状腺素(T4)、促甲状腺素(TSH)一般均在正常范围内,Graves病眼型患者T3、T4、TSH常常有不同程度增高。结论Graves病眼型应根据临床表现,实验室检查T3、T4、131I进行确诊,眼型Graves病排除甲状腺功能亢进外,眼眶X线片、B超排除眶内占位性病变以确诊。临床医师应提高对Graves病眼型和眼型Graves病的认识,以减少误诊和漏诊。

Objective To comparison the differences between Graves＇ophthalmopathy and ophthalmic Graves＇disease,then to provide a method of clinical diagnosis. Methods Clinical Clinical analysis and comparison of 69 Cases of Graves＂ ophthalmopathy and 38 cases of ophthalmic Graves＇disease. Resluts The resluts showed that both diseases had common ocular features of breomsymptom lid retraction, upper lid lag and ex- ophthalmos. Graves＇ophthalmopathy tended to be obvious symptoms, occured in binocular, exophthalmos with a longer courselater, but ophthalmic Graves disease patients were more of young people, most with no obvious symptoms ,occured in one eye exophthalmos. Triiodothyronine, thyroxine and thyrotropin in patients of ophthalmic Graves＇disease were usually in normal common level by laboratory examinations when in Graves＇ophthal- mopathy patients they were more higher. Conclusion We should give exact diagnosis on Grave＇s ophthalmopathy by laboratory examinations. Except for Hyperthyroidism,ophthalmic Graves＇disease＇ diagnosis should give X ray and B ultrasonography on orbit to eliminate site occupancy. Clinical doctor should improve recognition on Graves＇ophthalmopathy and ophthalmic Graves＇disease,to reduce misdiagnosis and missed diagnosis. comparison