张鹤

【摘要】 目的：探究大劑量糖皮质激素联合免疫抑制剂治疗甲亢眼病的效果并分析其安全性。方法：选取2017年5-10月本院收治的甲亢眼病患者180例，按照随机数字表法将其分为三组，每组60例。A组患者口服常规糖皮质激素治疗，B组患者行大剂量糖皮质激素冲击疗法治疗，C组采用大剂量糖皮质激素联合免疫抑制剂方案进行治疗。对三组患者的临床疗效以及体质量的增加、肝功能发生异常、并发糖尿病或者并发继发性高血压病等不良反应的发生率进行观察、统计，以判断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分析。结果：C组患者的总有效率为86.67%，明显高于A、B组的50.00%、60.00%，差异均有统计学意义（P<0.05）。用药后，三组皆有不良反应发生，A组患者不良反应发生率为73.33%，明显高于B、C组的26.67%、23.33%，差异均有统计学意义（P<0.05）；而B组与C组的不良反应发生率比较，差异无统计学意义（P>0.05）。结论：与单一的治疗方案相比，大剂量糖皮质激素联合免疫抑制剂治疗甲亢眼病的效果更好，且不良反应发生率更低，因此，此方案应在临床上进一步推广。

【关键词】 糖皮质激素； 免疫抑制剂； 甲亢眼病； 安全性

Effect and Security Analysis of High-dose Glucocorticoids Combined with Immune Inhibitors for the Treatment of Hyperthyroidism Eye Disease/ZHANG He.//Medical Innovation of China，2018，15（14）：119-122

【Abstract】 Objective：To explore effect of the high-dose glucocorticoids combined with immune inhibitors for the treatment of hyperthyroidism eye disease and analyze its related security.Method：A total of 180 cases of hyperthyroidism eye disease admitted from May to October 2017 in our hospital were retrospectively studied.According to the random number table method，they were divided into three groups，60 cases in each group.Group A was treated with regular oral glucocorticoid therapy，group B was treated with high-dose glucocorticoids shock therapy，group C was treated with high-dose glucocorticoids combined with immune inhibitors scheme.The clinical efficacy and incidence of adverse reactions such as the increase of the body mass，abnormal liver function，complicated diabetes mellitus or secondary hypertension were observed and counted，to evaluate the efficacy and security analysis of high dose glucocorticoid combined with immune inhibitors for the treatment of hyperthyroidism eye disease.Result：The total effective rate of group C was 86.67%，which was significantly higher than 50.00% and 60.00% of group A and B，the differences were statistically significant（P<0.05）.After medication，adverse reactions occurred in all three groups，the incidence of adverse reactions in group A was 73.33%，which was significantly higher than 26.67% and 23.33% in group B and C，the differences were statistically significant（P<0.05）.There were no significant differences between group B and group C（P>0.05）.Conclusion：Compared with single treatment，the high-dose glucocorticoids combined with immune inhibitors for the treatment of hyperthyroidism eye disease is more effective and has lower incidence of adverse reactions.therefore，it should be further popularized in clinic.

【Key words】 Glucocorticoid； Immune inhibitors； Hyperthyroidism eye disease； Security

First-authors address：The Peoples Hospital of Yingcheng，Yingcheng 432400，China

doi：10.3969/j.issn.1674-4985.2018.14.029

甲状腺相关眼病（thyroid associated ophthalmopathy，

TAO）是临床上最常见的眼眶疾病之一，1825年由Graves首次描述其临床症状，故被众多学者称为Graves疾病[1]。甲状腺相关眼病的临床表现因患者的特异性不同呈现出不同的臨床症状，具体临床症状表现为患者莫名流泪、怕光、视力下降且伴有异物感，还包括上睑迟落、眼结膜充血、眼球突出、眼睑萎缩以致眼睑闭合不全等病变[2]。典型的内分泌突眼病症是甲状腺肿大、双侧眼球突出、眼睑退缩。现今临床上常采用药物治疗、局部注射眼部、眼眶减压手术、针灸、各种药物等治疗方法[3]。……