甲基泼尼松龙联合曲安奈德治疗甲状腺相关性眼病患者的效果及对眼表疾病评分、临床活动度评分的影响

Effect of methylprednisolone combined with triamcinolone acetonide on thyroid-associated ophthalmopathy and its influence on Ocular Surface Disease Score and Clinical Activity Score

目的探究甲基泼尼松龙联合曲安奈德治疗甲状腺相关性眼病(thyroid-associated ophthalmopathy,TAO)患者的效果及对眼表疾病评分(Ocular Surface Disease Index, OSDI)、临床活动度评分(Clinical ActivityScore, CAS)评分的影响。方法选择TAO患者60例(120眼),按照随机数字表法分为观察组和对照组(每组均为30例60眼)。对照组患者使用甲基泼尼松龙治疗,观察组在对照组基础上使用曲安奈德治疗。比较2组患者治疗后的临床疗效和不良反应。检测并比较2组患者治疗前后的眼球突出度、睑裂宽度以及CAS评分和OSDI评分。结果治疗前2组眼球突出度和睑裂宽度差异无统计学意义(P>0.05),治疗后2组眼球突出度和睑裂宽度均显著改善(P<0.01),与对照组相比,观察组改善更明显(P<0.01).治疗前2组患者CAS评分和OSDI评分差异无统计学意义(P >0.05),治疗后2组CAS评分和OSDI评分均显著降低(P <0. 05),观察组降低更明显(P <0.05). 2组不良反应总发生率差异无统计学意义(P>0.05).结论甲基泼尼松龙与曲安奈德联合用药对TAO患者具有更好的临床疗效,可以显著降低患者的炎症反应并改善CAS评分和OSDI评分,预后更佳。

Objective To explore the effects of methylprednisolone combined with triamcinolone acetonide on thyroid -associated ophthalmopathy (TAO) and Ocular Surface Disease Index ( OSDI) and Clinical Activity Score ( CAS). Methods A total of 60 patients (120 eyes) with TAO were divided into two groups according to random number table: observation group and control group ( 30 cases and 60 eyes in each group). Patients in the control group were treated with methylprednisolone, while patients in the observation group were treated with triamcinolone acetonide on the basis of the control group. The clinical efficacy and adverse reactions were compared between the two groups after treatment. The exophthalmos ,width of palpebral fissure, CAS score and OSDI score before and after treatment were detected and compared between the two groups. Results There was no significant difference in the degree of exophthalmos and the width of palpebral fissure between the two groups before treatment (P >0.05). After treatment, the degree of exophthalmos and the width of palpebral fissure were significantly improved in both groups (P <0.01). Compared with the control group, the improvement of the degree of exophthalmos and the width of palpebral fissure in the observation group was more obvious (P <0.01). There was no significant difference in CAS score and OSDI score between the two groups before treatment (P >0.05). After treatment, CAS score and OSDI score in both groups decreased significantly (P <0.05), especially in the observation group (P <0.05). There was no significant difference in the total incidence of adverse reactions between the two groups (P >0.05). Conclusions The combination of methylprednisolone and triamcinolone acetonide has better clinical efficacy in TAO patients. It can significantly reduce inflammation, improve CAS score and OSDI score,and have better prognosis.