糖皮质激素不同用药途径对Graves突眼患者疗效、复发和病情稳定时间的影响  

Effects of different medication routes of glucocorticoid on the efficacy,recurrence and stabilization time of patients with Graves ophthalmopathy

作　　者：郭笑丹 王婷 GUO Xiaodan;WANG Ting(No.215 Hospital of Shaanxi Nuclear Industry,Xianyang 712000;Xi'an Fourth Hospital,Xi'an 710004,China)

机构地区：[1]陕西省核工业二一五医院,陕西咸阳712000 [2]西安市第四医院,陕西西安710004

出　　处：《临床医学研究与实践》2024年第25期30-33,共4页Clinical Research and Practice

基　　金：陕西省重点研发计划项目(No.2018SF-219)。

摘　　要：目的探究糖皮质激素不同用药途径对Graves突眼(GO)患者疗效、复发和病情稳定时间的影响。方法收集2020年1月至2021年12月接受治疗的60例GO患者为研究对象,按照区组随机化分组法将其分为口服组和静脉组,各30例。口服组服用醋酸泼尼松片进行治疗,静脉组选用醋酸泼尼松龙注射液治疗。比较两组的临床疗效、复发和病情稳定时间;分析影响GO复发的因素。结果静脉组的临床疗效显著优于口服组(P<0.05)。两组停药后12个月内的复发率比较,差异无统计学意义(P>0.05);静脉组的病情稳定时间长于口服组(P<0.05)。复发者的年龄明显小于未复发者,病情重度占比、高碘饮食占比及治疗结束时游离三碘甲腺原氨酸(FT3)水平明显高于未复发组(P<0.05)。Logistic回归分析结果显示,年龄是停药后GO复发的保护因素,高碘饮食和治疗结束时FT3水平是GO复发的危险因素(P<0.05)。结论与口服用药相比,糖皮质激素静脉冲击疗法能更好地治疗GO,延长病情稳定时间,但糖皮质用药途径并不会对复发率产生明显影响,停药后是否复发主要受患者年龄、是否高碘饮食和停药时机体FT3水平等影响。Objective To explore the effects of different medication routes of glucocorticoids on the efficacy,recurrence and stabilization time of disease in patients with Graves ophthalmopathy(GO).Methods A total of 60 GO patients who were treated from January 2020 to December 2021 were collected as the research objects.The patients were divided into oral group and intravenous group according to the block randomization grouping method,with 30 cases in each group.The oral group was treated with prednisone acetate tablets,and the intravenous group was treated with prednisolone acetate injection.The clinical efficacy,recurrence and stabilization time of disease in the two groups were compared;the factors affecting recurrence of GO were analyzed.Results The clinical efficacy of the intravenous group was significantly better than that of the oral group(P<0.05).There was no significant difference in the recurrence rate between the two groups within 12 months after drug withdrawal(P>0.05);the stable time of disease of the intravenous group was longer than that of the oral group(P<0.05).The age of patients with recurrence was significantly younger than that of patients without recurrence,the proportion of severe disease,the proportion of high iodine diet and the level of free triiodothyronine(FT3)at the end of treatment were significantly higher than those in the patients without recurrence(P<0.05).Logistic regression analysis results showed that age was a protective factor for GO recurrence after drug withdrawal,and high iodine diet and FT3 level at the end of treatment were risk factors for GO recurrence(P<0.05).Conclusion Compared with oral medication,glucocorticoid intravenous pulse therapy can better treat GO and prolong the stable time of the disease,but the glucocorticoid medication routes will not have a significant impact on the recurrence rate.Whether the recurrence after drug withdrawal is mainly affected by the patients'age,whether the iodine diet is high,and the body's FT3 level at the time of drug withdrawal.

关 键 词：Graves突眼 糖皮质激素 用药途径 复发 病情稳定时间 

分 类 号：R582[医药卫生—内分泌]