Graves眼病的糖皮质激素治疗

Graves眼病是指自身免疫性甲状腺疾病引起的眼眶炎症,主要累及眼外肌和球后脂肪产生突眼或眼外肌功能障碍.糖皮质激素通过免疫抑制和抗炎作用可使Graves眼病得到不同程度的缓解.本综述比较了口服、局部注射和静脉注射糖皮质激素三种治疗方法的疗效、副作用及用药指征,显示口服用药效果优于局部用药,静脉给药似乎优于口服,但副作用较大.发现Graves眼病需及早治疗,尤其是活动性眼病更需要治疗,防止眼病恶化,治疗时需权衡糖皮质激素的风险与获益.

Corticosteroids for treatment of Graves' ophthalmopathy

Graves＆#39; ophthalmopathy （GO） is an inflammatory eye disease that develops in the orbit in association with autoimmune thyroid disorders.Symptoms include mainly proptosis and extraocular muscle dysfunction due to involvement of both extraocular muscle and orbital fat.Corticosteroid theraphy can relieve GO via both immunomodulation and anti-inflammation.This review focuses on issues of the efficacy,side effects,and indications of corticosteroid therapy given by orally,subconjunctival / retrobulbar injections,versus intravenously.Corticosteroid therapy,when given orally,is more effective than given subconjunctivally,and given intravenously seemed to be the most effective,whereas more side effects in the treatment of GO.GO should be treated as early as possible,especially in patients with active inflammation to prevent the development or progression of GO.Corticosteroid therapy should be made in light of the risk-benefit ratio.