Graves眼病的临诊应对

Approach to the patients with Graves＇ ophthalmopathy

Graves眼病是Graves病最常见的甲状腺外表现，是一种器官特异性自身免疫病。估计每100000人群中每年有16名女性、3名男性发病。其中有3％～5％的Graves眼病患者病情严重．可危及视力，需要积极处理。对临床医师而言，正确评估该病的活动性及严重度对判断该病是否需要干预及采取何种干预措施非常有帮助。该病的干预措施主要包括控制甲亢，缓解局部症状，而对处于活动期的中重度眼病患者采取免疫抑制和治疗，处于非活动期的患者考虑予以康复手术。

Graves＇ ophthalmopathy （GO） is the most common extrathyroidal manifestation of Graves disease （GD）. It is an organ-specific autoimmune disorder. The estimated incidence of GO in the general population is 16 women and 3 men per 100,000 population every year. Approximately 3% -5% of patients with GO are exposed to the potential of losing their sight and requiring optimized medical intervention. For the clinicians it is helpful to assess the degree of activity and severity of GO ; both are important in deciding whether a patient requires intervention and which type of intervention is indicated. These interventions include management of hyperthyroidism, measures to relieve local symptoms, immunosuppressive therapies for active moderate and severe GO, and finally rehabilitative surgery for inactive oatients.