~(99)Tc-MDP与甲泼尼龙治疗Graves眼病的疗效比较
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摘要
目的比较甲泼尼松龙和99Tc-MDP治疗Graves眼病的疗效。方法选择2012年1月—2016年10月在大同市第五人民医院住院治疗的甲状腺相关眼病(Graves ophthalmopathy,简称GO)患者共60例。随机分为甲泼尼龙治疗组即激素组(30例)和99Tc-MDP组(30例),激素组应用甲泼尼龙500 mg溶于0.9%氯化钠注射液100 mL,静脉滴注,1次/日,连续3日,每隔4天再继续静脉滴注3天,连续3次,99Tc-MDP组将99Tc-MDP 10 mg,A剂注入B剂瓶内,充分混匀,在室温下静置5 min后加入生理盐水250 mL中静脉缓慢滴入,2～3 h滴完,21 d为1疗程。治疗前后比较患者自觉症状、突眼度、复视等的改善情况。结果激素组总有效率在GO活动性、突眼度、复视及眼球运动障碍的改善方面高于99Tc-MDP组(χ2=4.800,4.593,4.509,3.976,P=0.028,0.032,0.034,0.046)。结论甲泼尼龙治疗GO优于99Tc-MDP。
Objective To compare the clinical efficacy of ~(99)Tc-MDP and methylprednisolone in treatment of Graves' ophthalmopathy. Methods 60 patients with thyroid-associated ophthalmopathy were enrolled, who were hospitalized form January 2012 to October 2016 and randomly divided into the methylprednisolone therapy group(hormone group, 30 cases) and ~(99)Tc-MDP group(30 cases). Hormone group was treated with methylprednisolone 500 mg dissolved in 100 mL of 0.9% sodium chloride injection, intravenous drip, once a day, 3 consecutive days, after 4 days to continue intravenous drip for 3 days, altogether for 3 consecutive times. In ~(99)Tc-MDP group, ~(99)Tc-MDP was injected with 10 mg of agent A into the bottle of agent B, added to normal saline 250 mL, after 5 minutes at room temperature, ~(99)Tc-MDP was venous slowness Uniform infusion for 2～3 hours, 21 days for 1 courses. The improvement of conscious symptoms, exophthalmos and diplopia were compared before and after treatment. Results The total effective rate of the hormone group was significantly higher than that of the ~(99)Tc-MDP group in the improvement of GO activity, exophthalmos, diplopia and ocular movement disorders(χ2=4.800, 4.593, 4.509, 3.976, P=0.028, 0.032, 0.034, 0.046). Conclusion The effect of methylprednisolone is better than ~(99)Tc-MDP in treatment of Graves' ophthalmopathy.
Objective To compare the clinical efficacy of ~(99)Tc-MDP and methylprednisolone in treatment of Graves' ophthalmopathy. Methods 60 patients with thyroid-associated ophthalmopathy were enrolled, who were hospitalized form January 2012 to October 2016 and randomly divided into the methylprednisolone therapy group(hormone group, 30 cases) and ~(99)Tc-MDP group(30 cases). Hormone group was treated with methylprednisolone 500 mg dissolved in 100 mL of 0.9% sodium chloride injection, intravenous drip, once a day, 3 consecutive days, after 4 days to continue intravenous drip for 3 days, altogether for 3 consecutive times. In ~(99)Tc-MDP group, ~(99)Tc-MDP was injected with 10 mg of agent A into the bottle of agent B, added to normal saline 250 mL, after 5 minutes at room temperature, ~(99)Tc-MDP was venous slowness Uniform infusion for 2～3 hours, 21 days for 1 courses. The improvement of conscious symptoms, exophthalmos and diplopia were compared before and after treatment. Results The total effective rate of the hormone group was significantly higher than that of the ~(99)Tc-MDP group in the improvement of GO activity, exophthalmos, diplopia and ocular movement disorders(χ2=4.800, 4.593, 4.509, 3.976, P=0.028, 0.032, 0.034, 0.046). Conclusion The effect of methylprednisolone is better than ~(99)Tc-MDP in treatment of Graves' ophthalmopathy.
引文
[1]刘斌,胡忠惠.醋酸泼尼松联合环磷酰胺治疗甲亢浸润性突眼的疗效观察[J].现代诊断与治疗,2018,29(1):23-25.
[2]李妍,张宏彬,庞润晖,等.曲安奈德对甲状腺相关眼病上睑退缩的治疗效果及安全性分析[J].医学综述,2016,22(5):1032-1034.
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[5]赵嫦莹,黄春荣,朱彬彬.爆裂性眶壁骨折伴眼球运动障碍经针刺治疗的安全性及疗效分析[J].广州医药,2016,47(4):30-33.
[6]陈小玲,何为民,李薇.IGF-IR对甲状腺相关眼病眼眶成纤维细胞合成HA的影响及其作用机制[J].四川大学学报(医学版),2017,59(5):727-731.
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[9]高乐女,钟兵,王勇.锝[99Tc]亚甲基二膦酸盐治疗骨质疏松症的研究进展[J].中国骨质疏松杂志,2017,23(8):1094-1097.
[10]魏巧连,吕新亮.云克治疗类风湿关节炎的临床研究进展[J].世界最新医学信息文摘,2016,16(70):62-63.
[11]孙连增,梁丽芳,宋超宇,等.云克联合甲泼尼龙治疗Graves眼病的疗效研究以及突眼机制、预防措施的探讨[J].中国煤炭工业医学杂志,2012,15(10):1527-1528.
[11]汪茂荣.99Tcm-亚甲基二膦酸盐联合甲泼尼龙冲击治疗甲状腺相关眼病的效果观察[J].实用医技杂志,2014,21(11):1149-1150.
[12]袁磊,林海玲,丁福万.大剂量甲泼尼龙联合环磷酰胺治疗甲亢浸润性突眼的临床效果观察[J].实用临床医药杂志,2016,20(17):152,157.
[13]艾合买提江·由努斯.醋酸泼尼松联合环磷酰胺治疗甲亢浸润性突眼的疗效分析[J].中国处方药,2016,14(9):63-64.
[14]金晶,项楠,刘荣,等.球旁注射曲安奈德在甲状腺相关性眼病中的疗效观察[J].国际眼科杂志,2016,16(4):779-781.
[15]张亚萍,赵明利,黄克斌.甲亢眼病大剂量糖皮质激素冲击加免疫抑制剂治疗疗效及不良反应的临床研究[J].西北国防医学杂志,2012,33(1):23-25.
[15]张明伟.99Tc-MDP联合甲泼尼龙琥珀酸钠粉针冲击治疗甲状腺相关眼病的临床疗效[J].中国老年学杂志,2015,35(6):1674-1675.
[16]黄艳,谭兴普.云克与糖皮质激素治疗Graves眼病的临床分析[J].医学理论与实践,2008,21(4):448-449.
[16]苏建华,陈燕萍,包纪盛,等.糖皮质激素静脉冲击疗法与常规口服治疗在Graves眼病中应用的Meta分析[J].南京医科大学学报(自然科学版),2014,59(7):996-1000.
[2]李妍,张宏彬,庞润晖,等.曲安奈德对甲状腺相关眼病上睑退缩的治疗效果及安全性分析[J].医学综述,2016,22(5):1032-1034.
[3]高翔,蓝育青.中重度与极重度甲状腺相关眼病与甲状腺功能临床分析[J].临床眼科杂志,2018,26(2):160-163.
[4]张鹤.大剂量糖皮质激素联合免疫抑制剂治疗甲亢眼病的效果及其安全性分析[J].中国医学创新,2018,15(14):119-122.
[5]赵嫦莹,黄春荣,朱彬彬.爆裂性眶壁骨折伴眼球运动障碍经针刺治疗的安全性及疗效分析[J].广州医药,2016,47(4):30-33.
[6]陈小玲,何为民,李薇.IGF-IR对甲状腺相关眼病眼眶成纤维细胞合成HA的影响及其作用机制[J].四川大学学报(医学版),2017,59(5):727-731.
[7]杨静,王清,杨朝忠.免疫相关性眼病的免疫学治疗进展[J].国际眼科杂志,2018,18(2):263-266.
[8]王静.云克治疗甲亢伴浸润性突眼的应用效果与作用机制研究[J].临床医药文献电子杂志,2017,4(61):11908.
[9]高乐女,钟兵,王勇.锝[99Tc]亚甲基二膦酸盐治疗骨质疏松症的研究进展[J].中国骨质疏松杂志,2017,23(8):1094-1097.
[10]魏巧连,吕新亮.云克治疗类风湿关节炎的临床研究进展[J].世界最新医学信息文摘,2016,16(70):62-63.
[11]孙连增,梁丽芳,宋超宇,等.云克联合甲泼尼龙治疗Graves眼病的疗效研究以及突眼机制、预防措施的探讨[J].中国煤炭工业医学杂志,2012,15(10):1527-1528.
[11]汪茂荣.99Tcm-亚甲基二膦酸盐联合甲泼尼龙冲击治疗甲状腺相关眼病的效果观察[J].实用医技杂志,2014,21(11):1149-1150.
[12]袁磊,林海玲,丁福万.大剂量甲泼尼龙联合环磷酰胺治疗甲亢浸润性突眼的临床效果观察[J].实用临床医药杂志,2016,20(17):152,157.
[13]艾合买提江·由努斯.醋酸泼尼松联合环磷酰胺治疗甲亢浸润性突眼的疗效分析[J].中国处方药,2016,14(9):63-64.
[14]金晶,项楠,刘荣,等.球旁注射曲安奈德在甲状腺相关性眼病中的疗效观察[J].国际眼科杂志,2016,16(4):779-781.
[15]张亚萍,赵明利,黄克斌.甲亢眼病大剂量糖皮质激素冲击加免疫抑制剂治疗疗效及不良反应的临床研究[J].西北国防医学杂志,2012,33(1):23-25.
[15]张明伟.99Tc-MDP联合甲泼尼龙琥珀酸钠粉针冲击治疗甲状腺相关眼病的临床疗效[J].中国老年学杂志,2015,35(6):1674-1675.
[16]黄艳,谭兴普.云克与糖皮质激素治疗Graves眼病的临床分析[J].医学理论与实践,2008,21(4):448-449.
[16]苏建华,陈燕萍,包纪盛,等.糖皮质激素静脉冲击疗法与常规口服治疗在Graves眼病中应用的Meta分析[J].南京医科大学学报(自然科学版),2014,59(7):996-1000.