注射用甲泼尼龙琥珀酸钠联合环磷酰胺治疗甲亢浸润性突眼患者的效果

Effects of Methylprednisolone sodium succinate for injection combined with Cyclophosphamide in treatment of patients with Graves ophthalmopathy

目的:观察注射用甲泼尼龙琥珀酸钠联合环磷酰胺治疗甲状腺功能亢进症(甲亢)浸润性突眼患者的效果。方法:选取96例甲亢浸润性突眼患者为研究对象,按照随机数字表法分为观察组与对照组各48例。两组均给予基础治疗,在此基础上,对照组给予醋酸泼尼松片联合环磷酰胺治疗,观察组给予注射用甲泼尼龙琥珀酸钠联合环磷酰胺治疗,比较两组临床疗效、睑裂宽度、眼球突出度、甲亢眼病临床活动性评分(CAS评分)、甲状腺激素[游离甲状腺素(FT_(4))、三碘甲状腺原氨酸(FT_(3))]水平和不良反应发生率。结果:观察组治疗总有效率为93.75%,明显高于对照组的75.00%,差异有统计学意义(P<0.05);治疗后,两组睑裂宽度、眼球突出度和CAS评分均低于治疗前,且观察组明显低于对照组,差异有统计学意义(P<0.05);治疗后,两组FT_(4)和FT_(3)水平均低于治疗前,且观察组明显低于对照组,差异有统计学意义(P<0.05);观察组不良反应发生率为12.50%,明显低于对照组的35.42%,差异有统计学意义(P<0.05)。结论:注射用甲泼尼龙琥珀酸钠联合环磷酰胺治疗甲亢浸润性突眼患者可提高治疗总有效率,降低睑裂宽度、眼球突出度、CAS评分、FT_(4)水平、FT_(3)水平和不良反应发生率,效果优于醋酸泼尼松片联合环磷酰胺治疗。

Objective:To observe effects of Methylprednisolone sodium succinate for injection combined with Cyclophosphamide in treatment of patients with Graves ophthalmopathy(hyperthyroidism).Methods:96 patients with Graves ophthalmopathy were selected as the research objects,and were divided into observation group and control group according to the random number table method,48 cases in each group.Both groups were given basic treatment.On this basis,the control group was given Prednisone acetate tablets combined with Cyclophosphamide treatment,while the observation group was given Methylprednisolone sodium succinate for injection combined with Cyclophosphamide treatment.The clinical effects,the palpebral fissure width,the degree of exophthalmus,the clinical activity score(CAS score)of Graves ophthalmopathy,the thyroid hormone[free thyroxine(FT_(4)),triiodothyronine(FT_(3))]levels,and the occurrence rate of adverse reactions were compared between the two groups.Results:The total effective rate of treatment in the observation group was 93.75%,which was significantly higher than 75.00%in the control group,and the difference was statistically significant(P<0.05).After the treatment,the palpebral fissure width,the degrees of exophthalmus and the CAS scores in the two groups were lower than those before the treatment;those of the observation group were significantly lower than those of the control group;and the differences were statistically significant(P<0.05).After the treatment,the levels of FT_(4) and FT_(3) in the two groups were lower than those before the treatment;those of the observation group were significantly lower than those of the control group;and the differences were statistically significant(P<0.05).Further,the incidence of adverse reactions in the observation group was 12.50%,which was significantly lower than 35.42%in the control group,and the difference was statistically significant(P<0.05).Conclusions:Methylprednisolone sodium succinate for injection combined with Cyclophosphamide in the treatment of the patients with Graves ophthalmopathy can improve the total effective rate of treatment,and reduce the palpebral fissure width,the degrees of exophthalmus and the CAS score,FT_(4) level,FT_(3) level and the incidence of adverse reactions.Moreover,it is superior to Prednisone acetate tablets combined with Cyclophosphamide treatment.