(99)Tc-MDP联合环磷酰胺、注射用甲泼尼龙琥珀酸钠治疗Graves眼病的临床疗效

Clinical efficacy of(99)TC-MDP combined with cyclophosphamide and sodium methylprednisolone succinate in the treatment of Graves ophthalmopathy

目的分析(99)Tc-MDP联合环磷酰胺、注射用甲泼尼龙琥珀酸钠治疗Graves眼病(GO)的临床疗效。方法选取我院收治的GO患者84例,采用随机数字表法分为观察组与对照组,每组42例。对照组予以环磷酰胺、注射用甲泼尼龙琥珀酸钠联合治疗,观察组在此基础上予以(99)Tc-MDP治疗。对比两组临床疗效、不良反应以及治疗前后临床活动度评分(CAS)、促甲状腺受体抗体(TRAb)、促甲状腺素(TSH)及甲状腺刺激免疫球蛋白(TSI)水平。结果观察组疗效高于对照组(P<0.05);治疗后两组CAS评分低于治疗前,观察组低于对照组(P<0.05);观察组血清TSH水平高于对照组,血清TSI、TRAb水平低于对照组(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论 (99)Tc-MDP联合环磷酰胺、注射用甲泼尼龙琥珀酸钠治疗GO患者效果显著,可有效改善临床症状,调节血清TSH、TSI、TRAb水平,且无显著不良反应。

Objective To analyze the clinical efficacy of(99)Tc-MDP combined with cyclophosphamide and methyl⁃prednisolone succinate in the treatment of Graves ophthalmopathy(GO).Methods 84 cases of patients with GO were se⁃lected and randomly divided into the observation group and the control group,42 cases in each group.The control group was treated with cyclophosphamide and sodium methylprednisolone succinate,while the observation group was added(99)Tc-MDP on the basis of the control group.The clinical efficacy,adverse reactions,clinical activity score(CAS),serum levels[thyroid stimulating receptor antibody(TRAb),thyrotropin(TSH)and thyroid-stimulating immunoglobulin(TSI)]before treatment and after treatment were compared between the two groups.Results The total effective rate in the observation group was significantly higher than that in the contol group(P<0.05).After treatment,CAS scores of the two groups were lower than those before treatment,and that of the observation group was lower than that in the control group(P<0.05).After treatment,the serum TSH level in the observation group was higher than that in the control group,while the serum TSI and TRAb levels in the observation were lower than those in the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion(99)Tc-MDP combined with cyclophos⁃phamide and sodium methylprednisolone succinate has significant effect in the treatment of GO,which can effectively im⁃prove clinical symptoms and regulate serum TSH,TSI and TRAb levels without significant adverse reactions.