活动性甲状腺相关眼病可控危险因素及治疗进展

Controllable Risk Factors and Treatment Progress of Active Thyroid Associated Ophthalmopathy

甲状腺相关眼病(thyroid associated ophthalmopathy,TAO),常见于Graves病,又称Graves眼病,常发生在双侧眼,部分患者有自愈倾向。临床症状多表现为上睑退缩、眶周组织水肿、眼球突出等,进一步发展可能会影响患者的视力,甚至导致失明。目前,TAO的发病机制尚不完全清楚,受遗传、环境等多种因素影响,自身免疫功能异常被认为是TAO的主要发病因素。目前激素治疗仍为TAO的一线治疗方案,但现免疫靶向治疗取得重大进展,为TAO的治疗提供了新的选择。治疗的选择应基于对临床活动和严重程度的评估。本文就TAO的可控危险因素及治疗进行综述,以期为临床上治疗方式的选择提供帮助。

Thyroid associated ophthalmopathy(TAO)is common in Graves'disease,also known as Graves'ophthalmopathy,which often occurs in both eyes.Some patients have tendency of self healing,with clinical symptoms of upper eyelid retraction,periorbital tissue edema,and exophthalmos.Further development may affect vision patients,even cause blindness.Currently,pathogenesis of TAO is not fully understood.Due to various factors including genetics and environment,autoimmune dysfunction is considered to be main pathogenesis of TAO.Currently,hormone therapy is the first line treatment for TAO,but significant progress has been made in immunotargeted therapy,and provided new options for treatment of TAO,which should be based on assessment of clinical activity and severity.The article reviews controllable risk factors and TAO treatment to provide assistance for selection of clinical treatment methods.