甲状腺相关眼病210例临床资料分析

Clinical analysis of 210 cases of thyroid-associated ophthalmopathy

目的总结甲状腺相关眼病（TAO）病程特点、临床特征及疾病的影响因素，为临床早期诊断和治疗方案的选择提供依据。方法对2009年1月至2011年1月在上海长征医院眼科就诊的210例（380只眼）TAO患者的临床资料进行回顾性分析。结果甲功正常者多单眼发病（80．0％）；眼睑征以上眼睑退缩为最常见共257只眼（67．6％）；眼外肌受累共349只眼（91．8％），以下直肌增粗多见；行I^131治疗后发生了眼征或眼征加重为多（63．1％）。结论甲状腺相关眼病有其自身的发病特点，在临床工作中，通过关注患者眼部病变特征、甲状腺功能状态有助于尽早确诊甲状腺相关眼病．及时采取有效措施。

Objective To summarize the course features, clinical manifestation and disease factors of thyroid-associated ophthalmopathy （TAO）, and to make accurate diagnosis for TAO. Methods We retrospective analyzed 210 cases with TAO diagnosed in Changzheng Hospital to summarize the characteristics of clinical symptoms and signs. Results Patients with euthyroidism often involved single eye （80%）. The grade IV of TAO occurred more frequently in patients with abnormal thyroid function than those with euthyroidism. Upper eyelid retraction was the most common sign of the eyelid lesion （67.6%）. About 349 eyes （91.8%） were rectus enlargement; the inferior rectus was the most frequently involved. TAO occurred or aggravated in 63.1% case treated with I^131. Conclusions TAO has its own clinical characteristics and natural course. In clinical work, by focusing patients＇ characteristics of ocular lesions and thyroid function to make accurate diagnosis earlier, witch is essential for instituting treatment and predicting prognosis.