甲状腺功能正常性Graves眼病与甲亢性Graves眼病的配对比较分析及随访观察

A PairMatched Comparison and Followup Study of Patients with Euthytroid Graves Ophthalmopathy and Patients with Hyperthyroid Graves Ophthalmopathy

为了解甲状腺功能正常性Ｇｒａｖｅｓ眼病（ＥＧＯ）与甲亢性Ｇｒａｖｅｓ眼病（ＨＧＯ）的异同以及ＥＧＯ的转归，对２７例ＥＧＯ与ＨＧＯ进行配对比较，并对ＥＧＯ进行了随访。结果：在同期病程中，ＥＧＯ组的复视、双眼突度差≥２ｍｍ、闭合不全、眼球活动受限及角膜受累者较ＨＧＯ组多，而视神经受累者ＨＧＯ组较多。两组眼病指数，经ｔ检验无显著性差异（Ｐ＞０．０５）。ＥＧＯ组的疗效优于ＨＧＯ组。对１８例ＥＧＯ患者１～６年随访显示，在病程演进的５月至３年间，６１％发生甲亢和甲状腺肿大；３９％６年内仍未发生甲亢，说明ＥＧＯ既与甲状腺疾病有相关性，又可以是一种“孤立”存在的自身免疫性疾病。

This study was intended to acquire a knowledge about the similarity and difference between euthyriod Graves ophthalmopathy (EGO) and hyperthyroid Graves ophthalmopathy (HGO), and about the outcome of the EGO cases. Twentyseven EGO patients were pairmatched with 27 HGO patients, and 18 of the EGO patients were followed up for 16 years. The results showed that the EGO group had markedly more patients with diplopia, failure to close lids, limitation of eyeball movements, cornea involvement, and more patients with a difference of two eyes' exophthalmos degrees 2 mm,but the HGO group had more patients with optic nerve involvement. No significant difference was found between the two groups' ophthalmopathic indexes by using the ttest.Drug therapy of the EGO group was more efficacious than that of the HGO group. The results of followup study showed that 61% of the EGO cases had hyperthyroidism and goiter within 5 months to 3 years, but 39% of the cases had no hyperthyroidism up to 6 years. These data suggest that EGO is associated with thyroid diseases and it can stand alone as an autoimmune disease.