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目的:探讨激素冲击治疗联合放疗用于中重度Graves眼病的临床疗效。方法:将2014年2月~2015年6月之间我院收治的109例中重度Graves眼病患者随机分为A组(n=37)、B组(n=35)、C组(n=37)。A组患者单纯采用抗甲状腺药物治疗,B组患者则在A组的基础上进行激素冲击治疗,C组患者则采用B组基础上联合球后放疗方案治疗,所有患者治疗后保持随访至少6个月,对比三组疗效,记录三组患者治疗前、治疗6个月时的临床活动评分(CAS)及眼球突出度,及随访期间不良反应情况。结果:三组有效率比较,C组>B组>A组,差异有统计学意义(P<0.05)。治疗后三组CAS评分均显著优于治疗前(P<0.05),且C组显著低于A、B组(P<0.05),A、B组间比较无显著差异(P>0.05)。治疗后B、C组眼球突出度显著低于治疗前(P<0.05),且C组显著低于A、B组(P<0.05)。A、B、C三组不良反应发生率分别为0、14.29%、5.41%,A、C组比较无显著差异(P>0.05),B组不良反应发生率明显高于A、C组(P<0.05)。结论:激素冲击联合放疗治疗中重度Graves眼病具有显著的疗效,能够有效降低患者的CAS评分及眼球突出度,效果明显优于单纯抗甲状腺治疗或激素冲击治疗,且安全性较好,值得在临床上推广和应用。
Objective: To investigate the clinical effect of hormone shock therapy combined with radiotherapy for Graves ophthalmopathy. Methods: A total of 109 patients with moderate and severe Graves ophthalmopathy admitted to our hospital from February 2014 to June 2015 were randomly divided into group A (n = 37), group B (n = 35), group C (n = 37) ). Patients in group A were treated with antithyroid drugs alone, patients in group B received hormone shock therapy on the basis of group A, and patients in group C were treated with combination of retrobulbar radiotherapy on the basis of group B. All patients were followed up for at least 6 months Month, and compared the efficacy of three groups. The scores of clinical activity (CAS) and eyeball protrusion, and the adverse reactions during the follow-up period were recorded before treatment and 6 months after treatment in the three groups. Results: The three groups of effective rate comparison, C group> B group> A group, the difference was statistically significant (P <0.05). After treatment, the CAS scores of three groups were significantly better than those before treatment (P <0.05), and those of group C were significantly lower than those of group A and B (P <0.05). There was no significant difference between groups A and B (P> 0.05). After treatment, the degree of eyeball protrusion in group B and C was significantly lower than that before treatment (P <0.05), and in group C was significantly lower than that in group A and B (P <0.05). The adverse reactions in group A, B and C were 0,14.29% and 5.41% respectively, there was no significant difference between group A and C (P> 0.05). The incidence of adverse reactions in group B was significantly higher than that in group A and C <0.05). Conclusion: Hormone shock combined with radiotherapy has a significant curative effect on moderate and severe Graves ophthalmopathy, which can effectively reduce the CAS score and the degree of prominence of the patients. The effect is better than that of anti-thyroid or hormone therapy alone and is safe and worthy of clinical application On the promotion and application.