甲基强的松龙冲击联合球后放疗治疗中重度Graves眼病的临床研究

Clinical Study on Methylprednisolone Combined with Orbital Radiotherapy for Treatment of Moderate-to-severe Graves Ophthalmopathy

目的观察甲基强的松龙冲击治疗联合球后放疗对中重度Graves眼病的临床疗效。方法中重度Graves眼病患者90例,根据治疗方法不同分为3组:对照组35例接受抗甲状腺药物治疗;激素组32例接受甲基强的松龙冲击治疗;联合组23例接受甲基强的松龙冲击治疗和球后放疗。记录治疗前后各组患者眼球突出度、Graves眼病临床活动评分(CAS)。结果治疗过程中各组患者均未发生严重不良反应。联合组、激素组疗效明显优于对照组(P<0.05),联合组疗效明显优于激素组(P<0.05);治疗后3组CAS评分、眼球突出度均明显低于治疗前(P<0.05),且下降幅度为联合组>激素组>对照组(P<0.05)。结论甲基强的松龙冲击联合球后放疗治疗中重度Graves眼病安全、有效。

Objective To investigate the clinical outcome of methylprednisolone combined with orbital radiotherapy for the treatment of moderate-to-severe Graves ophthalmopathy. Methods Ninety patients with moderate-to-severe Graves ophthalmopathy were divided into three groups according to the therapies they received. Thirty-five cases in the control group received antithyroid drug therapy,32 cases in the glucocorticoid group were treated with methylprednisolone,and 23 cases in the combination group were given methylprednisolone pulse orbital radiotherapy. The degree of exophthalmos and clinical activity score（ CAS） were observed before and after treatment in two groups. Results No severe side effects were observed in all patients during treatment. The combination group and glucocorticoid group showed better effects compared with control group（ P〈0. 05）,and the combination group showed better effects compared with glucocorticoid group（ P〈0. 05）. The degrees of exophthalmos and CAS scores after treatment were significantly lower than those before treatment in the three groups（ P〈0. 05）,the decrease was largest in the combination group,and was smallest in the control group（ P〈0. 05）. Conclusion Methylprednisolone combined with orbital radiotherapy is an safe and effective therapy for moderate-to-severe Graves ophthalmopathy.