糖皮质激素冲击疗法治疗重症甲状腺相关眼病26例

目的临床观察糖皮质激素冲击疗法治疗重症甲状腺相关眼病(thyroidassociatedophthalmopathy,TAO)患者的疗效。方法静脉点滴甲基强的松龙1.0g/d,连续3d后改为静脉点滴甲基强的松龙0.5g/d,连续2d后改为清晨顿服强的松龙40mg/d。每2周递减5mg,同时每月眶周注射康尼克通-A40mg 地塞米松5mg,连续3次。结果26例重症TAO患者临床表现有明显改善,有效率为85%。疗效与有无甲状腺功能异常无统计学意义,并且疗效与发病时间的长短有明显相关性。结论糖皮质激素冲击疗法治疗重症TAO有明显疗效。

High-dose corticosteroid therapy for 26 patients with severe thyroid associated ophthalmopathy

Aim To observe the clinical outcome of high-dose corticosteroid thera py in severe thyroid-associated ophthalmopathy (TAO). Methods Methylprednisolon e was administered through intravenous instillation, 1.0g/d for 3 days and then 0.5g/d for 2 days. Then oral hydroprednisone was used early in the morning, star ting with 40mg/d and the dosage was reduced by 5mg every 2 weeks. In the meantim e, Kenacort-A 40mg dexamethasone 5mg was given by periorbital injection once e very month for 3 months successively. Results The clinical response was evaluat ed as excellent in 21 patients and the effective rate was 85%. The therapeutic e ffect was not statistically related to whether there is abnormal thyroid functio n, but it was remarkably correlated with the duration of the disease. Conclusion High-dose corticosteroid is an effective treatment for severe TAO.