^(99)Tc-MDP与甲泼尼龙治疗Graves眼病的疗效比较

Clinical Efficacy Comparison on ^(99)Tc-MDP and Methylprednisolone Treatment for Graves' Ophthalmopathy

目的比较甲泼尼松龙和99Tc-MDP治疗Graves眼病的疗效。方法选择2012年1月—2016年10月在大同市第五人民医院住院治疗的甲状腺相关眼病(Graves ophthalmopathy,简称GO)患者共60例。随机分为甲泼尼龙治疗组即激素组(30例)和99Tc-MDP组(30例),激素组应用甲泼尼龙500 mg溶于0.9%氯化钠注射液100 mL,静脉滴注,1次/日,连续3日,每隔4天再继续静脉滴注3天,连续3次,99Tc-MDP组将99Tc-MDP 10 mg,A剂注入B剂瓶内,充分混匀,在室温下静置5 min后加入生理盐水250 mL中静脉缓慢滴入,2～3 h滴完,21 d为1疗程。治疗前后比较患者自觉症状、突眼度、复视等的改善情况。结果激素组总有效率在GO活动性、突眼度、复视及眼球运动障碍的改善方面高于99Tc-MDP组(χ2=4.800,4.593,4.509,3.976,P=0.028,0.032,0.034,0.046)。结论甲泼尼龙治疗GO优于99Tc-MDP。

Objective To compare the clinical efficacy of 99Tc-MDP and methylprednisolone in treatment of Graves'ophthalmopathy.Methods 60 patients with thyroid-associated ophthalmopathy were enrolled,who were hospitalized form January 2012 to October 2016 and randomly divided into the methylprednisolone therapy group(hormone group,30 cases)and 99Tc-MDP group(30 cases).Hormone group was treated with methylprednisolone 500 mg dissolved in 100 mL of 0.9%sodium chloride injection,intravenous drip,once a day,3 consecutive days,after 4 days to continue intravenous drip for 3 days,altogether for 3 consecutive times.In 99Tc-MDP group,99Tc-MDP was injected with 10 mg of agent A into the bottle of agent B,added to normal saline 250 mL,after 5 minutes at room temperature,99Tc-MDP was venous slowness Uniform infusion for 2~3 hours,21 days for 1 courses.The improvement of conscious symptoms,exophthalmos and diplopia were compared before and after treatment.Results The total effective rate of the hormone group was significantly higher than that of the 99Tc-MDP group in the improvement of GO activity,exophthalmos,diplopia and ocular movement disorders(χ^2=4.800,4.593,4.509,3.976,P=0.028,0.032,0.034,0.046).Conclusion The effect of methylprednisolone is better than 99Tc-MDP in treatment of Graves'ophthalmopathy.