甲基强的松龙静脉冲击周方案治疗中重度甲状腺相关眼病疗效分析  

Efficacy of intravenous methylprednisolone weekly plan in treatment of moderate to severe thyroid associated ophthalmopathy

作　　者：王丽[1] 姜惠[1] 徐志刚[1] 吴晨光[1] 

机构地区：[1]江苏大学附属人民医院(镇江市第一人民医院),212002

出　　处：《齐齐哈尔医学院学报》2017年第18期2140-2141,共2页Journal of Qiqihar Medical University

摘　　要：目的观察甲基强的松龙静脉冲击周方案治疗中重度甲状腺相关眼病短期临床疗效及不良反应。方法分析2014年6月至2016年12月住院甲基强的松龙静脉冲击周方案治疗(静脉滴注甲基泼尼松龙,剂量为每周500 mg,持续6周,然后减量为每周250 mg,再持续6周)的33例中重度甲状腺相关眼病患者资料,对患者畏光、流泪、眼部软组织充血、水肿、眼球疼痛、复视一系列临床表现进行治疗前后比较。结果治疗后,患者畏光、流泪、自发性球后疼痛、眼球运动时疼痛、眼睑水肿、球结膜充血、眼睑充血、球结膜水肿、泪阜水肿均明显改善。患者CAS评分(1.0±0.5)分,显著低于治疗前GAS评分(4.0±0.9)分,差异有统计学意义(t=43.084,P<0.001)。结论甲基强的松龙静脉冲击周方案治疗中重度甲状腺相关眼病,短期疗效肯定,严格入选患者可避免严重不良反应。Objective To observe the short-term clinical efficacy and side effects of intravenous glucocorticoid therapy for moderate-to-severe thyroid associated ophthalmopathy. Methods A total of 33 patients with moderate-to-severe thyroid associated ophthalmopathy were investigated from June 2014 to December 2016,the patients were treated with intravenous methylprednisolone weekly（ intravenous methylprednisolone,a dose of500 mg per week,for 6 weeks,then the 250 mg per week,for 6 weeks）. For patients with photophobia,tears,eye soft tissue hyperemia,edema,eye pain,diplopia,a series of clinical manifestations were compared before and after treatment. Results After treatment,patients with photophobia,tears,spontaneous pain,eye movement when the ball after the pain,eyelid edema,conjunctival hyperemia,eyelid hyperemia,chemosis,lacrimal caruncle edema were significantly improved. The CAS score（ 1±0.5） was significantly lower than the GAS score（ 4±0.9） before treatment,and the difference was statistically significant（ t= 43.084,P〈0.001）.Conclusions Weekly intravenous glucocorticoid therapy is effective in the treatment of moderate-to-severe thyroid associated ophthalmopathy,which can avoid severe adverse reactions.

关 键 词：甲状腺相关眼病 甲基强的松龙冲击 

分 类 号：R771.3[医药卫生—眼科]