甲氨蝶呤片联合甲基强的松龙治疗Graves眼病临床疗效观察

发布时间：2018-08-01 10:20

【摘要】：目的观察甲氨蝶呤片联合甲基强的松龙治疗Graves眼病的疗效。方法选择中重度Graves眼病患者84例作为研究对象,采用随机数字表法分成两组,每组42例。对照组患者给予生理盐水250 m L+甲基强的松龙300 mg静脉滴注治疗,1次/周,治疗8周;联合组患者在对照组治疗的基础上加服甲氨蝶呤片7.5 mg治疗,1次/周,治疗8周。观察比较两组患者治疗后血常规、肝肾功能、血糖、眼球突出度、各种眼征及眼球运动情况;对两组患者进行CAS评分和NOSPECS分级评估比较;每4周复查甲状腺功能1次,随访6个月。结果治疗后,两组患者NOSPECS分级、CAS评分均显著下降(P0.05),对照组患者CAS评分低于联合组(P0.05);随访半年,联合组患者复发率明显低于对照组(P0.05)。结论甲氨蝶呤片联合甲基强的松龙治疗Graves眼病安全有效,能显著降低患者的复发率。
[Abstract]:Objective to observe the efficacy of methotrexate tablets combined with methylprednisolone in the treatment of Graves ophthalmopathy. Methods Eighty-four patients with moderate and severe Graves ophthalmopathy were randomly divided into two groups, 42 cases in each group. The patients in the control group were given normal saline 250 mL methylprednisolone 300 mg intravenous drip once a week for 8 weeks, while the patients in the combined group were treated with methotrexate 7.5 mg once a week for 8 weeks on the basis of the treatment in the control group. To observe and compare the blood routine, liver and kidney function, blood sugar, eyeball exophthalmos, all kinds of eye sign and eyeball movement after treatment, to evaluate and compare the CAS score and NOSPECS grade of the two groups, to recheck thyroid function once every 4 weeks. Follow-up for 6 months. Results after treatment, the scores of NOSPECS grade were significantly decreased in both groups (P0.05), and the CAS scores in the control group were lower than those in the combined group (P0.05), and the recurrence rate in the combined group was significantly lower than that in the control group for half a year (P0.05). Conclusion Methotrexate combined with methylprednisolone is safe and effective in the treatment of Graves ophthalmopathy.
【作者单位】：中国人民解放军第413医院内分泌科;广西百色市人民医院中医科;
【分类号】：R581;R771.3

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