甲状腺相关眼病的临床分析  

Clinical analysis of thyroid-associated ophthalmopathy

作　　者：郑大文[1] 王宏[1] 罗燕[1] 

机构地区：[1]山西省眼科医院,中国山西省太原市030002

出　　处：《国际眼科杂志》2009年第7期1371-1373,共3页International Eye Science

摘　　要：目的:分析甲状腺相关眼病(thyroid-associated ophthalmopa-thy,TAO)的临床特点,为诊断和治疗提供依据。方法:回顾性分析我院自2001-07/2007-10就诊的268例473眼TAO患者的临床资料。结果:在268例就诊的TAO患者中,甲状腺功能异常者213例(79.5%),眼睑退缩299眼(63.2%),迟落261眼(55.2%),眼睑肿胀277眼(58.6%),球结膜充血、水肿164眼(36.7%),角膜点状上皮脱落39眼(8.3%),角膜溃疡8例(1.7%),眼球突出422例(89.2%),眼压升高者43例(16.0%)69眼(14.6%),眼球运动受限332眼(70.2%),其中单方面眼球运动受限者143眼(43.1%),单方面眼球运动受限顺序依次是下转,内转,上转,外转,多方面眼球运动受限者176眼(53.0%),眼球固定13眼(3.9%),复视71例(26.5%),影像学肌肉测量,眼外肌受累频率由高到低依次是下直肌、上直肌、内直肌、外直肌,视神经病变者31例(11.6%)57眼。结论:TAO的发病多与甲腺功能有关,临床表现有自身特点,大多数患者易于诊断,对于不典型病例要注意眼征特点,眼外肌受累情况以及影像学意义。AIM： To analyze the clinical characteristic of thyroid- associated ophthalmopathy（TAO） so as to provide bases for the diagnosis and treatment. METHODS：The clinical data of 268 patients （473 eyes） with TAO from July 2001 to October 2007 in our hospital was analyzed retrospectively. RESULTS： There were 213 eyes （79.5%） of glandula thyreoidea disfunction, 299 eyes （63. 2%） of lid retraction, 261 eyes （55.2%） of delay shed, 277 eyes （58.6%） of eyelid engorgement, 164 eyes （36.7%） of conjunctivat congestion, dropsy, 39 eyes （8. 3%） of keratoderma punctiform EPI defluvium, 8 eyes （1. 7%） of corneal ulcer, 422 eyes （89.2%） of exophthalmos, 69 eyes （14.6%） of intraocular tension step up in 43 patients （ 16.0% ）, 332 eyes （70.2%） of ocular limitation of movement. Among the total, one-sided ocular limitation of movement eyes were 143 （43.1%）, the order of one-sided ocular limita- tion of movement was deorsumduction, adversion, superduction and exodeviation. Versatility ocular limitation of movement eyes were 176 （53. 0%）, eye globe fixing 13（3. 9%）, ambiopia 71 （26. 5%）; According to muscle measure of imageology , the frequency of EOM to be involved from high to low was inferior rectus, superior rectus muscle, internal rectus muscle, external rectus muscle. The optic neuropathy patients were 31 （ 11.6% ）, totally 57 eyes. CONCLUSION： The morbidity of TAO is related to abnormal thyroid function, and the clinical manifestation has its own characteristics, so the most cases are easy to diagnose. It is important to pay attention to the eye symptoms, extraocular muscle involvement and imaging significance for alypical cases.

关 键 词：甲状腺相关眼病 眼球突出 眼内压 眼外肌 视神经 

分 类 号：R771.3[医药卫生—眼科] R777.5[医药卫生—临床医学]