激素冲击治疗活动期甲状腺相关眼病后的眼表变化  

Influence of the Pulsed Corticosteroids Therapy for Active Thyroid Associated Ophthalmopathy on Ocular Surface

作　　者：康剑书[1] 孙晓梅[1] 赵志坚[1] 张红[1] KANG Jian-shu;SUN Xiao-mei;ZHAO Zhi-jian;ZHANG Hong(Dept.of Ophthalmology,The Second people's Hospital of Yunnan Province,Kunming Ynnan 650021, China)

机构地区：[1]云南省第二人民医院眼科,云南昆明650021

出　　处：《昆明医科大学学报》2018年第12期74-76,共3页Journal of Kunming Medical University

基　　金：云南省卫生科技计划基金资助项目(2016NS183)

摘　　要：目的分析活动期甲状腺相关眼病患者静脉使用甲泼尼龙琥珀酸钠针冲击治疗后眼表的变化。方法选择临床活动性评分(CAS)≥4的活动期甲状腺相关眼病患者31例(共62眼),静脉使用激素冲击治疗,于治疗前及治疗后1周用Keratograph眼表综合分析仪测量中央泪河高度(tear river height,TMH)、泪膜破裂时间(tear break-up time,BUT)、角膜荧光素染色(corneal fluorescentstaining,FS)及眼红分析(R-scan),并行基础泪液分泌(schirmerⅠtest, SIt)试验检查。结果与治疗前相比,治疗后1周泪河高度增加(P<0.05)、泪膜破裂时间延长(P<0.05),眼红明显好转(P<0.05),角膜荧光染色及SchirmerⅠ分泌无明显改善(P>0.05)。结论活动期甲状腺相关眼病患者在使用静脉激素改善眼球周围软组织炎症的同时,眼表环境也进一步改善。Objective To investigate the changes of pulsed corticosteroids therapy for active thyroid associated ophthalmopathy on ocular surface.Methods A total of 31 patients(62 eyes)with active Thyroid associated ophthalmopathy(CAS≥4 points)were investigated.Keratograph ophthalmograph analyzer,together with schirmerⅠtest(SIt),was used to measure the height of the central tear stream(TMH),tear break-up time(BUT),schirmerⅠtest(SIt),corneal fluorescent staining(FS)and R-scan before and one week after the treatment.Results Tear break-up time(BUT),tear stream height and R-scan were all improved after treatment(P<0.05).But schirmerⅠtest(SIt),corneal fluorescent staining(FS)were not considerably different between the two tests(P >0.05).Conclusion In patients with active thyroid associated ophthalmopathy,the ocular surface environment was further improved while pulsed corticosteroids therapy was used to improve the inflammation of the surrounding soft tissue of the eyeball.

关 键 词：甲状腺相关眼病 激素 眼表 

分 类 号：R581[医药卫生—内分泌]