Graves病合并胫前黏液性水肿采用激素冲击联合曲安奈德皮下多点注射治疗的临床效果探讨

Effect of steroid pulse therapy combined with multiple subcutaneous injections of triamcinolone acetonide on skin lesions of Graves’ disease complicated with pretibial myxedema

目的 探讨毒性弥漫性甲状腺肿(Graves病)合并胫前黏液性水肿患者采用激素冲击联合曲安奈德皮下多点注射治疗的临床效果。方法 78例Graves病合并胫前黏液性水肿患者,根据随机摸球法分成观察组与对照组,各39例。对照组给予激素冲击治疗,观察组给予激素冲击联合曲安奈德皮下注射治疗。比较两组临床疗效、不良反应发生情况及治疗前后免疫功能、炎性因子水平。结果 观察组治疗总有效率92.31%高于对照组的74.36%,差异具有统计学意义(P<0.05)。治疗后,两组免疫球蛋白G(IgG)、免疫球蛋白M(IgM)、免疫球蛋白A(IgA)、C反应蛋白(CRP)、降钙素原(PCT)及白细胞介素-6(IL-6)水平均低于治疗前,且观察组IgG、IgM、IgA、CRP、PCT及IL-6水平分别为(11.64±3.21)g/L、(1.08±0.23)g/L、(2.52±0.39)g/L、(15.27±1.01)mg/L、(0.63±0.22)ng/ml、(42.32±5.38)pg/ml,低于对照组的(17.93±3.58)g/L、(1.76±0.37)g/L、(3.34±0.46)g/L、(18.54±1.11)mg/L、(1.18±0.45)ng/ml、(57.64±3.71)pg/ml,差异具有统计学意义(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 Graves病合并胫前黏液性水肿患者采用激素冲击联合曲安奈德皮下多点注射治疗,能够提高临床疗效,减轻机体免疫反应与炎症反应,且不会增加不良反应。

Objective To discuss the clinical effect of steroid pulse therapy combined with multiple subcutaneous injections of triamcinolone acetonide on skin lesions of toxic diffuse goiter(Graves’ disease)complicated with pretibial myxedema.Methods A total of 78 patients with Graves’ disease and pretibial myxedema were divided into observation group and control group according to the randomized ball-touching method,with 39 cases in each group.The control group was treated with steroid pulse therapy,and the observation group was treated with steroid pulse therapy combined with subcutaneous injection of triamcinolone acetonide.The clinical efficacy,occurrence of adverse reactions and the levels of immune function and inflammatory factors before and after treatment were compared between the two groups.Results The total effective rate of treatment in the observation group was 92.31%,which was higher than 74.36% in the control group,and the difference was statistically significant(P0.05).Conclusion The combination of steroid pulse therapy and multiple subcutaneous injections of triamcinolone acetonide in patients with Graves’ disease and pretibial myxedema can improve the clinical efficacy,reduce the immune and inflammatory reactions,and will not increase the adverse reactions.