~(131)I联合甲泼尼龙治疗Graves眼病的临床疗效研究
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摘要
目的探讨~(131)I联合甲泼尼龙治疗Graves眼病的临床疗效。方法选取2013年7月—2015年1月鹤壁市人民医院收治的Graves眼病患者90例,采用随机数字表法分为对照组与试验组,各45例。对照组患者给予131I治疗,试验组在对照组治疗基础上给予甲泼尼龙治疗。观察两组患者Graves病临床疗效、Graves眼病临床疗效、治疗前后甲状腺体积和突眼度及不良反应发生情况。结果两组患者Graves病临床疗效比较,差异无统计学意义(P>0.05)。试验组Graves眼病治疗总有效率高于对照组,差异有统计学意义(P<0.05)。治疗前两组患者甲状腺体积、突眼度比较,差异无统计学意义(P>0.05);治疗后试验组患者甲状腺体积、突眼度小于对照组,差异有统计学意义(P<0.05)。两组患者不良反应发生率比较,差异无统计学意义(P>0.05)。结论131I联合甲泼尼龙治疗Graves眼病的临床疗效确切,可有效改善患者的临床症状,提高治疗有效率,减小突眼度和甲状腺体积,且安全性较高。
Objective To disccuss the clinical efficacy of131 I combined with methylprednisolone in treating Graves ophthalmopathy. Methods A total of 90 cases of patients with Graves ophthalmopathy were selected from to July 2013 to January 2015 in Hebi People's Hospital,which were randomly divided into the control group and the experiment group,45 cases in each group. The control group was treated with131 I,the experiment group was treated with methylprednisolone treatment on the basis of control group. The clinical efficacy of the Graves disease and Graves ophthalmopathy,thyroid volume and the degree of exophthalmos before and after the treatment,and adverse reactions of two groups were observed. Results There was no significant differences of clinical efficacy of Graves disease between two groups( P > 0. 05). The total effective rate of Graves ophthalmopathy of the experiment group was higher than that of control group,the difference was statistically significant( P < 0. 05).Before treatment,there was no statistically significant differences of the thyroid volume or exophthalmos degree between two groups( P > 0. 05); after treatment,the thyroid volume or exophthalmos degree of the experiment group were less than those of control group,the differences were statistically significant( P < 0. 05). There was no significant differences of the incidence of adverse reactions between two groups( P > 0. 05). Conclusion131 I combined with methylprednisolone have an exact curative effect in the treatment of Graves ophthalmopathy,it can effectively relieve the patients' clinical symptoms,improve the treatment efficiency,and reduce the degree of exophthalmos and thyroid volume,and the safety is high..
Objective To disccuss the clinical efficacy of131 I combined with methylprednisolone in treating Graves ophthalmopathy. Methods A total of 90 cases of patients with Graves ophthalmopathy were selected from to July 2013 to January 2015 in Hebi People's Hospital,which were randomly divided into the control group and the experiment group,45 cases in each group. The control group was treated with131 I,the experiment group was treated with methylprednisolone treatment on the basis of control group. The clinical efficacy of the Graves disease and Graves ophthalmopathy,thyroid volume and the degree of exophthalmos before and after the treatment,and adverse reactions of two groups were observed. Results There was no significant differences of clinical efficacy of Graves disease between two groups( P > 0. 05). The total effective rate of Graves ophthalmopathy of the experiment group was higher than that of control group,the difference was statistically significant( P < 0. 05).Before treatment,there was no statistically significant differences of the thyroid volume or exophthalmos degree between two groups( P > 0. 05); after treatment,the thyroid volume or exophthalmos degree of the experiment group were less than those of control group,the differences were statistically significant( P < 0. 05). There was no significant differences of the incidence of adverse reactions between two groups( P > 0. 05). Conclusion131 I combined with methylprednisolone have an exact curative effect in the treatment of Graves ophthalmopathy,it can effectively relieve the patients' clinical symptoms,improve the treatment efficiency,and reduce the degree of exophthalmos and thyroid volume,and the safety is high..
引文
[1]陈晓丽,沙益锋,沈莉敏,等.Graves病甲亢患者血清甲状腺激素水平与血脂水平的相关性[J].西部医学,2016,28(2):218-220.
[2]梁雯丽,郑艳,李娜,等.Graves甲亢患者131I治疗后早期TRAb及TSAb变化的研究分析[J].国际放射医学核医学杂志,2016,40(1):13-16,34.
[3]易圣蓝,刘纯.感染在自身免疫性甲状腺疾病发病中的作用[J].中华微生物学和免疫学杂志,2015,35(7):556-558.
[4]刘然,杨倩琳,赵丽,等.1221例未治疗成年Graves病患者肝功能指标异常情况及相关因素分析[J].中华内分泌代谢杂志,2015,11(6):497-500.
[5]黄莲,徐向进,林忆阳,等.亚急性甲状腺炎同时合并Graves病的临诊应对[J].中华内分泌代谢杂志,2015,31(4):363-365.
[6]倪青,李卉,林伟,等.病证结合诊疗方案治疗Graves病207例自身对照研究[J].中国临床医生杂志,2015,43(11):55-56.
[7]宣锦花,秦凌云.甲基泼尼松龙冲击治疗Graves眼病40例观察与护理[J].中外医学研究,2011,9(30):65-66.
[8]吴霞.大剂量甲基泼尼松龙治疗Graves眼病临床分析[J].中国医药科学,2011,1(18):60,63.
[9]刘新亮.甲基泼尼松龙脉冲治疗Graves'眼病[J].现代中西医结合杂志,2010,19(12):1446-1447,1449.
[10]杨青,邓欣莲,冯清辉.甲基泼尼松龙静脉冲击治疗Graves眼病36例观察与护理[J].当代护士:下旬刊,2015,11(6):81-82.
[2]梁雯丽,郑艳,李娜,等.Graves甲亢患者131I治疗后早期TRAb及TSAb变化的研究分析[J].国际放射医学核医学杂志,2016,40(1):13-16,34.
[3]易圣蓝,刘纯.感染在自身免疫性甲状腺疾病发病中的作用[J].中华微生物学和免疫学杂志,2015,35(7):556-558.
[4]刘然,杨倩琳,赵丽,等.1221例未治疗成年Graves病患者肝功能指标异常情况及相关因素分析[J].中华内分泌代谢杂志,2015,11(6):497-500.
[5]黄莲,徐向进,林忆阳,等.亚急性甲状腺炎同时合并Graves病的临诊应对[J].中华内分泌代谢杂志,2015,31(4):363-365.
[6]倪青,李卉,林伟,等.病证结合诊疗方案治疗Graves病207例自身对照研究[J].中国临床医生杂志,2015,43(11):55-56.
[7]宣锦花,秦凌云.甲基泼尼松龙冲击治疗Graves眼病40例观察与护理[J].中外医学研究,2011,9(30):65-66.
[8]吴霞.大剂量甲基泼尼松龙治疗Graves眼病临床分析[J].中国医药科学,2011,1(18):60,63.
[9]刘新亮.甲基泼尼松龙脉冲治疗Graves'眼病[J].现代中西医结合杂志,2010,19(12):1446-1447,1449.
[10]杨青,邓欣莲,冯清辉.甲基泼尼松龙静脉冲击治疗Graves眼病36例观察与护理[J].当代护士:下旬刊,2015,11(6):81-82.