激素冲击治疗联合放疗对中重度Graves眼病临床疗效分析

发布时间：2018-06-18 01:56

  本文选题：Graves眼病 + 激素冲击　； 参考：《现代生物医学进展》2016年24期

【摘要】：目的:探讨激素冲击治疗联合放疗用于中重度Graves眼病的临床疗效。方法:将2014年2月~2015年6月之间我院收治的109例中重度Graves眼病患者随机分为A组(n=37)、B组(n=35)、C组(n=37)。A组患者单纯采用抗甲状腺药物治疗,B组患者则在A组的基础上进行激素冲击治疗,C组患者则采用B组基础上联合球后放疗方案治疗,所有患者治疗后保持随访至少6个月,对比三组疗效,记录三组患者治疗前、治疗6个月时的临床活动评分(CAS)及眼球突出度,及随访期间不良反应情况。结果:三组有效率比较,C组B组A组,差异有统计学意义(P0.05)。治疗后三组CAS评分均显著优于治疗前(P0.05),且C组显著低于A、B组(P0.05),A、B组间比较无显著差异(P0.05)。治疗后B、C组眼球突出度显著低于治疗前(P0.05),且C组显著低于A、B组(P0.05)。A、B、C三组不良反应发生率分别为0、14.29%、5.41%,A、C组比较无显著差异(P0.05),B组不良反应发生率明显高于A、C组(P0.05)。结论:激素冲击联合放疗治疗中重度Graves眼病具有显著的疗效,能够有效降低患者的CAS评分及眼球突出度,效果明显优于单纯抗甲状腺治疗或激素冲击治疗,且安全性较好,值得在临床上推广和应用。
[Abstract]:Objective: to investigate the clinical effect of hormone shock therapy combined with radiotherapy for moderate and severe Graves ophthalmopathy. Methods: from February 2014 to June 2015, 109 patients with moderate and severe Graves ophthalmopathy in our hospital were randomly divided into two groups: group A, group B, group A, group B patients treated with antithyroid drugs only, and group B patients treated with antithyroid drugs, on the basis of group A, the patients in group B were treated with antithyroid drugs. The patients in group C were treated with group B combined with Retrobulbar radiotherapy. All patients were followed up for at least 6 months to compare the efficacy of the three groups. The clinical activity score (CAS) and the degree of exophthalmos were recorded before and after treatment in the three groups, and the adverse reactions during the follow-up period were also recorded. Results: the effective rate of three groups was higher than that of C group B group A, the difference was statistically significant (P 0.05). After treatment, the CAS scores in the three groups were significantly better than those in the pre-treatment group (P 0.05), and the scores in group C were significantly lower than those in group A (P 0.05) and there was no significant difference between the two groups (P 0.05). After treatment, the degree of exophthalmos in group B was significantly lower than that in group B (P 0.05), and the incidence of adverse reactions in group C was significantly lower than that in group A (P 0.05). The incidence of adverse reactions in group C was significantly higher than that in group A (P 0.05). Conclusion: hormone shock combined with radiotherapy is effective in treating moderate and severe Graves' ophthalmopathy. It can effectively reduce CAS score and eyeball exophthalmos of patients with Graves' ophthalmopathy. The effect is obviously better than that of antithyroid therapy or hormone shock therapy, and the safety is good. It is worth popularizing and applying in clinic.
【作者单位】： 济宁市第一人民医院内分泌科;
【分类号】：R771.3;R581
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本文编号：2033487