甲状腺相关眼病病情严重程度95例影响因素研究  

Factors related to severity of thyroid associated ophthalmopathy in 95 cases

作　　者：戈荧[1] 沈洁[1] 范艳飞[1] 刘仕群[1] 李际敏[1] 李云倩[1] 陈志[1] 

机构地区：[1]南方医科大学南方医院内分泌科,广州510515

出　　处：《中国实用内科杂志》2011年第9期707-709,共3页Chinese Journal of Practical Internal Medicine

基　　金：;广东省科技计划项目(2009B11400036)

摘　　要：目的研究甲状腺相关眼病(tyroid associated ophthalmopathy,TAO)病情严重程度的相关影响因素。方法回顾性分析2008年1月至2010年6月在南方医科大学南方医院内分泌科确诊的资料完整的95例TAO患者的临床资料,TAO的确诊参照Bartley标准,根据NOSPECS和磁共振(MRI)图像将TAO病情严重程度分为:轻度、中至重度、危及视力3个级别。用Logistic回归分析法分析95例TAO患者临床资料,如年龄、性别、吸烟史、Graves病治疗方式、甲状腺功能、甲状腺自身抗体(TRAb)等相关影响因素与TAO病情严重程度的关系。结果由于自变量间存在共线性,病情严重程度的影响因素用logitic多元有序回归分析显示:只有吸烟(β=-1.505,P=0.005)和促甲状腺素受体抗体(β=0.031,P=0.005)2个变量进入回归方程。结论甲状腺相关眼病的发生发展受多方面因素的影响,戒烟、恢复并维持甲状腺功能及其自身抗体水平的正常能够预防或改善甲状腺相关眼病的发生发展。Objective To investigate the factors related to severity of thyroid associated ophthalmopathy （TAO）. Methods Complete clinical data of 95 patients with TAO registered to Department of Endocrinology of Nanfang Hospital between January 2008 and June 2010 were reviewed. The diagnosis of TAO was determined according to Bartley criteria. Based on NOSPECS and magnetic resonance imaging （MRI） , the severity of TAO was rated as mild, moderate to severe, and sight-threatening. Logistic regression analysis was used to analyze the clini- cal data of 95 TAO patients including age, gender, cigarette smoking, treatments for Graves＇s disease, thyroid functions,TSH-R antibodies （TRAb） as related to the Severity of TAO. Results Since the multicollinearity existed a- mong independent variables, only two variables, cigarette smoking （ β = - 1. 505, P = 0. 005 ） and TRAb （ β= 0. 031, P = 0. 005 ） , were included in the regression equation as revealed by ordinal multinomial logistic regression models. Conclusion The development and progression of TAO may be affected by various factors. Smoking cessa- tion, recovering and maintaining the thyroid functions, and normal TSHR level might prevent or improve the development and progression of TAO.

关 键 词：甲状腺相关眼病 病情严重程度 多元有序回归 

分 类 号：R581.1[医药卫生—内分泌]