甲状腺相关眼病的临床疗效分析

Clinical analysis on treatment effect of 98 cases of thyroid-associated ophthalmopathy

目的观察几种治疗方法对甲状腺相关眼病(TAO)患者的临床疗效。方法对98例(161只眼)TAO患者的临床资料进行回顾性分析。结果TAO患者多发生于40岁以上的中年人(70.5%),性别无明显差异;以眼球突出、眼睑退缩和复视为主要就诊原因,70%以上的患者有眼征和眼外肌受累;98例患者中,甲状腺功能正常者53例,甲状腺功能异常者(甲状腺功能亢进39例、甲状腺功能低下6例)45例。其中60例应用糖皮质激素冲击治疗,病情明显改善;31例行手术治疗后病情得到控制,4例放射治疗后病情稳定,手术及放射治疗的同时应用糖皮质激素治疗;3例行糖皮质激素、放射及手术3种方法联合治疗后病情平稳。结论甲状腺相关眼病应用糖皮质激素冲击治疗是关键,病变严重者辅助以放射治疗或眼眶手术治疗,可收到满意的效果。

Objective To summarize and analyze the effect on the therapy on thyroid-associated ophthalmopathy by all ways. Methods Ninety eight TAO cases（ 161 eyes） were collected from 2002 to 2007 and their clinical manifestations were summarized and analyzed. Results TAO occurred mostly in individuals over 40 years with no gender preference （70. 5 % ） ;Exophthalmos, retraction of eyelids and diplopia were their major manifestations and main reasons for ophthalmic exanination. Retraction of eyelids and involvement of extraocular muscle were present in over 70% cases. In 98 TAO cases, enthyroidsm was found in 53 cases and abnormal thyroid function （ hyperthyroidism 39 or hypothyroidism 6） was present in 45 cases. 60 cases＇ conditions were improved apparently after the therapy of glucocoricoid hormone; 31cases＇ conditions were controlled by operations ; 4cases＇ conditions were stationary after the therapy of radiation and ; Simultaneously, glucocoricoid hormone was used; 3cases＇ conditions were stationary after the combined therapy of glucocoricoid hormone, operations and radiation. Conclusion Effect of the therapy on thyroid-associated ophthalmopathy was key; Added radiation therapy and operations to those with serious conditions, the effects were satisfaetified.