甲亢眼病大剂量糖皮质激素冲击加免疫抑制剂治疗疗效及不良反应的临床研究

Effects and adverse reactions of high-dose corticosteroids plus immunosuppressive therapy for treating hyperthyroidism eye diseases

目的:了解大剂量甲强龙冲击加小剂量免疫抑制剂治疗甲亢眼病的临床疗效和不良反应情况,以评估该治疗方案的临床应用价值。方法:选取我院2006-01～2010-01住院及门诊治疗的甲亢眼病64例,随机分为大剂量甲强龙冲击加免疫抑制剂治疗组(A组)和单纯大剂量甲强龙冲击治疗组(B组)及常规口服糖皮质激素治疗组(C组)。结果:①治疗半年后A组的有效率及显效率显著高于其他两组,且组间比较有显著性差异(P<0.05);②A组不良反应的发生情况与B组无统计学差异(P>0.05),但A、B组与C组比较不良反应有下降,且有统计学差别(P<0.05)。结论:大剂量甲强龙联合小剂量免疫抑制剂治疗甲亢突眼临床治疗效果显著提高,不良反应较单一治疗无明显增加,较常规口服激素治疗有下降,是值得临床广泛应用的治疗方法。

Objective：To investigate the effects and adverse reactions of high-dose corticosteroids plus immunosuppressive therapy for hyperthyroidism eye disease and assess the clinical value of the treatment.Methods： A total of 64 patients were included in this study,who were hospitalized form Jan.2006 to Jan.2010 or as an outpatient,and were randomly divided into the high-dose methylprednisolone plus immunosuppressive therapy group（A）,high-dose methylprednisolone therapy group（B）,and conventional oral glucocorticoid hormone therapy group（C）.Results： After six months of treatment,the efficacious rate in group A was significantly higher than that of the other two group（P0.05）.The incidence of adverse reactions in group A was not different with that of group B（P0.05）,but the incidence in group A and B was significantly lower than that of group C（P0.05）.Conclusion： High-dose methylprednisolone plus low-dose immunosuppressive therapy for hyperthyroidism exophthalmos significantly improves clinical outcomes.The adverse events were not increased compared to the simple high-dose methylprednisolone therapy,and were decreased comparaed to conventional oral hormone therapy,which indicated that it is worthy of application widely.