| 甲强龙环磷酰胺联合99Tc亚甲基二磷酸盐治疗甲状腺相关眼病的临床有效性及安全性 |
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| 引用本文： | 邵蔚,石勇铨,王云,梁进,武昆. 甲强龙环磷酰胺联合99Tc亚甲基二磷酸盐治疗甲状腺相关眼病的临床有效性及安全性[J]. 蚌埠医学院学报, 2019, 44(11): 1487-1489, 1493. DOI: 10.13898/j.cnki.issn.1000-2200.2019.11.014 |
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| 作者姓名： | 邵蔚 石勇铨 王云 梁进 武昆 |
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| 作者单位： | 淮南东方医院集团总院 内分泌科,安徽 淮南,232001;上海第二军医大学附属长征医院 内分泌科,上海,200001 |
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| 摘 要： | 目的探讨甲强龙环磷酰胺联合99Tc亚甲基二磷酸盐（99Tc-MDP）治疗甲状腺相关眼病（thyroid-associated ophthalmopathy，TAO）的临床有效性及安全性。方法选取内分泌科收治的TAO病人50例，按治疗方案的不同将病人分为对照组22例和观察组28例。对照组采用甲强龙、环磷酰胺治疗方案；观察组采用甲强龙、环磷酰胺联合99Tc-MDP治疗方案。比较2组病人治疗前后眼外肌厚度、临床活动性评分（CAS）和病情严重情况及不良反应发生率。结果治疗前，2组病人CAS评分、眼外肌厚度和病情严重率差异均无统计学意义（P>0.05）。治疗后，2组病人CAS评分和病情严重率均较治疗前明显下降（P < 0.01），观察组病人眼外肌厚度亦明显低于治疗前（P < 0.01），且观察组治疗后的CAS评分、病情严重率和眼外肌厚度均低于对照组（P < 0.05~P < 0.01）。观察组病人治疗期间不良反应发生率为5.36%（3/56），低于对照组的20.45%（9/44）（P < 0.05）。结论甲强龙环、磷酰胺方案联合使用99Tc-MDP治疗TAO，可有效改善病人临床疗效，减少相关不良反应的发生，值得临床推广。
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| 关 键 词： | 甲状腺相关眼病 甲强龙 环磷酰胺 99Tc亚甲基二磷酸盐 |
| 收稿时间： | 2019-07-19 |
Study on the clinical efficacy and safety of methylprednisolone and cyclophosphamide combined with 99Tc-MDP in the treatment of thyroid-associated ophthalmopathy |
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| Affiliation: | 1.Department of Endocrinology, The General Hospital of Huainan Oriental Hospital Group, Huainan Anhui 2320012.Department of Endocrinology, Changzheng Hospital Affiliated to Shanghai Second Military Medical University, Shanghai 200001, China |
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| Abstract: | ObjectiveTo investigate the clinical efficacy and safety of methylprednisolone and cyclophosphamide combined with 99Tc-MDP in the treatment of thyroid-associated ophthalmopathy(TAO).MethodsFifty patients with TAO were divided into the control group(22 cases) and observation group(28 cases) according to the treatment schemes.The control group was treated with methylprednisolone and cyclophosphamide, and the observation group was treated with methylprednisolone and cyclophosphamide combined with 99Tc-MDP.The thickness of extraocular muscle, clinical activity score(CAS) and severity of disease before and after treatment, and incidence rate of adverse reactions were compared between two groups.ResultsBefore treatment, the differences of the CAS score, thickness of extraocular muscle and severity of disease between two groups were not statistically significant(P>0.05).After treatment, the CAS score and severity of disease in two groups significantly decreased compared with before treatment(P < 0.01), the thickness of extraocular muscle in the observation group was significantly lower than that before treatment, and the CAS score, severity of disease and thickness of extraocular muscle in observation group were lower than those in control group(P < 0.05 to P < 0.01).The incidence rate of adverse reactions during treatment in observation group(5.36%) was lower than that in control group(20.45%)(P < 0.05).ConclusionsThe methylprednisolone and cyclophosphamide combined with 99Tc-MDP in the treatment of TAO can effectively improve the clinical efficacy and reduce the occurrence of adverse reactions, which is worthy of clinical promotion. |
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