醋酸泼尼松+环磷酰胺治疗甲亢合并突眼的临床疗效及血清TRAb、IL-1变化研究  

Study on the clinical efficacy of prednisone acetate+cyclophosphamide in the treatment of hyperthyroidism with exophthalmos and the changes of serum TRAb and IL-1

作　　者：王笑雄[1] 王小霞 郭锬[3] 陈彤[1] WANG Xiao-xiong;WANG Xiao-xia;GUO Yong(Department of Ophthalmology,Beijing Hospital,Beijing 100730,China;Department of Endocrinology,Beijing Hospital,Beijing 100730,China;Department of Radiology,Beijing Hospital,Beijing 100730,China)

机构地区：[1]北京医院眼科,北京100730 [2]北京医院内分泌科,北京100730 [3]北京医院放射科,北京100730

出　　处：《临床和实验医学杂志》2021年第2期187-190,共4页Journal of Clinical and Experimental Medicine

基　　金：北京医院青年课题(编号:BJ201284)。

摘　　要：目的探讨醋酸泼尼松+环磷酰胺治疗甲亢合并突眼的临床疗效及血清促甲状腺激素受体抗体(TRAb)、白细胞介素-1(IL-1)变化研究。方法前瞻性选取2016年5月至2019年12月北京医院收治的64例甲亢合并突眼患者,采用随机数字表法将其分为2组:对照组(n=30)予以常规甲亢治疗,研究组(n=34)在常规治疗基础上应用醋酸泼尼松+环磷酰胺治疗。观察2组患者甲亢指标、突眼疗效及血清TRAb、IL-1水平变化。结果治疗后8周2组患者游离三碘甲状腺原氨酸(FT3)、游离甲状腺激素(FT4)、总三碘甲状腺原氨酸(TT3)和总甲状腺素(TT4)水平均较治疗前明显降低(P<0.05),而促甲状腺激素(TSH)水平显著增高(P<0.05);治疗后8周研究组FT3、FT4、TT3、TT4水平均明显低于对照组(P<0.05),TSH水平明显高于对照组(P<0.05);研究组临床总有效率为91.18%,明显高于对照组(76.67%),组间比较差异有统计学意义(P<0.05);治疗后8周2组患者血清TRAb、IL-1水平均显著降低(P<0.05),且治疗后8周研究组TRAb、IL-1水平均明显低于对照组,差异有统计学意义(P<0.05)。结论醋酸泼尼松+环磷酰胺可改善甲亢合并突眼患者甲状腺功能和突眼症状,下调TRAb、IL-1水平,可作为甲亢合并突眼的有效治疗方法。Objective To explore the clinical efficacy of prednisone acetate+cyclophosphamide in the treatment of hyperthyroidism with exophthalmos and study on the changes of serum thyroid-stimulating hormone receptor antibody(TRAb)and interleukin-1(IL-1).Methods From May 2016 to December 2019,64 patients with hyperthyroidism and exophthalmia admitted to Beijing Hospital were prospectively selected and divided into 2 groups by random number table:the control group(n=30)received conventional hyperthyroidism treatment,and the study group(n=34)received acetic acid on the basis of conventional treatment.Prednisone+cyclophosphamide treatment,observation of hyperthyroidism indicators,exophthalmia efficacy and serum TRAb and IL-1 levels in the two groups.Results After 8 weeks of treatment,the levels of free triiodothyronine(FT3),free thyroid hormone(FT4),total triiodothyronine(TT3)and total thyroxine(TT4)in the 2 groups were significantly lower than before treatment(P<0.05),while the level of thyroid-stimulating hormone(TSH)was significantly increased(P<0.05);After 8 weeks of treatment,the levels of FT3,FT4,TT3,and TT4 in the study group were significantly lower than those in the control group(P<0.05),and the TSH level was significantly higher than the control group(P<0.05)The total clinical effective rate of the study group was 91.18%,which was significantly higher than that of the control group(76.67%),and the difference between the groups was statistically significant(P<0.05).After 8 weeks of treatment,the serum TRAb and IL-1 levels of the two groups were significantly reduced(P<0.05),and after treatment,the levels of TRAb and IL-1 in the study group were significantly lower than those in the control group(P<0.05).Conclusion Prednisone acetate+cyclophosphamide can improve thyroid function and thyroid function in patients with hyperthyroidism and exophthalmia Exophthalmos symptoms,down-regulating the levels of TRAb and IL-1 can be used as an effective treatment for hyperthyroidism with exophthalmos.

关 键 词：甲亢 突眼 醋酸泼尼松 环磷酰胺 促甲状腺激素受体抗体 炎症反应 

分 类 号：R581.1[医药卫生—内分泌] R771.3[医药卫生—内科学]