甲基强的松龙联合环磷酰胺冲击治疗甲状腺相关眼病疗效评价

Methylprednisolone Combined with Cyclophosphamide in Treating Thyroid-Associated Ophthalmopathy

目的探讨甲基强的松龙联合环磷酰胺冲击治疗甲状腺相关眼病(TAO)的疗效。方法将收治的54例TAO患者分为两组,应用糖皮质激素联合环磷酰胺冲击治疗为联合组(31例),单纯糖皮质激素冲击治疗为单药组(23例),比较两组患者的临床疗效、不良反应发生情况及临床指标变化。结果联合组治疗总有效率为90.32%,明显高于单药组的60.87%(P<0.05);联合组不良反应发生率为32.26%,单药组为26.09%,两组比较,差异无统计学意义(P>0.05)。治疗前,两组患者眼球突出度、睑裂宽度及肌肉厚度比较,差异均无统计学意义(P>0.05),治疗后两组患者均有所改善,但联合组改善程度明显优于单药组(P<0.05)。结论甲基强的松龙联合环磷酰胺较单用甲基强的松龙冲击TAO疗效更佳,不良反应发生率则无差异。

Objective To observe the efficacy of methylprednisolone combined with cyclophosphamide and methylprednisolone monotherapy for the treatment of thyroid-associated ophthalmopathy（TAO）.Methods 54 patients with TAO were divided into two groups.Patients treated with glucocorticoid combined with cyclophosphamide was the combination treatment group（31 cases） and patients treated with glucocorticoid shock therapy alone was the single drug treatment group（23 cases）.The clinical efficacy,incidence of adverse reactions and changes in clinical indicators in the two groups were compared.Results The total effective rate in the combination treatment group was 90.32%,which was significantly higher than 60.87%in the single drug treatment group（P〈0.05）.The incidence of adverse reactions in the combination treatment group was 32.26%,and 26.09%in the single drug group,with no statistically significant difference between the two groups（P〉0.05）.Before treatment,there was no significant difference in the degree of exophthalmus,palpebral fissure width and muscle thickness between the two groups（P〉0.05）,but the improvement of the combination treatment group was better than that of the single drug treatment group（P〈0.05）.Conclusion Methylprednisolone combined with cyclophosphamide in treating TAO has better efficacy than using methylprednisolone alone,and the adverse reactions had no statistical difference.