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1、1734GuangxiMedicalJournal，Dec．2014，f．36，No．12甲基強(qiáng)的松龍沖擊聯(lián)合球后放療治療中重度Graves眼病的臨床研究▲黃澤鋒程時(shí)武。黎南中謝紋文玉梅何燮勇王磊邵麗(1中國人民解放軍總政治部機(jī)關(guān)門診部，北京市100120，E—mail：huangzefeng5566@sina．com；2中國人民解放軍第303醫(yī)院內(nèi)分泌科，南寧市530021)【摘要】目的觀察甲基強(qiáng)的松龍沖擊治療聯(lián)合球后放療對(duì)中重度Graves眼病的臨床療效。方法中重度Graves眼病患者90例，根據(jù)治療方法不同分為3組：對(duì)照組35
2、例接受抗甲狀腺藥物治療；激素組32例接受甲基強(qiáng)的松龍沖擊治療；聯(lián)合組23例接受甲基強(qiáng)的松龍沖擊治療和球后放療。記錄治療前后各組患者眼球突出度、Graves眼病臨床活動(dòng)評(píng)分(CAS)。結(jié)果治療過程中各組患者均未發(fā)生嚴(yán)重不良反應(yīng)。聯(lián)合組、激素組療效明顯優(yōu)于對(duì)照組(P<0．05)，聯(lián)合組療效明顯優(yōu)于激素組(P<0．05)；治療后3組CAS評(píng)分、眼球突出度均明顯低于治療前(P<0．05)，且下降幅度為聯(lián)合組>激素組>對(duì)照組(P<0．05)。結(jié)論甲基強(qiáng)的松龍沖擊聯(lián)合球后放療治療中重度Graves眼病安全、有效。【關(guān)鍵詞】Graves眼??；糖皮
3、質(zhì)激素；球后放療；甲基強(qiáng)的松龍【中圖分類號(hào)】R581．1【文獻(xiàn)標(biāo)識(shí)碼】A【文章編號(hào)】0253—4304(2014)12—1734—03DoI：1O．11675／j．issn．0253—4304．2014．12．17ClinicalStudyonMethylprednisoloneCombinedwithOrbitalRadiotherapyforTreatmentofModerate—to-severeGravesOphthalmopathyHUANGZe-feng，CHENGShi—y3U2，Nan．zhong，XIEWen2，W
4、ENYu—mei，HEXie—yong，WANGLei，SHAOLi(1Departmentof0口fnfClinic，GeneralPoliticalDepartmentofPeopleLiberationArmy，Beijing100120，China；2DepartmentofEndocrinology，No．303HospitalofPeopleSLiberationArmy，Nanning530021，China)【Abstract】ObjectiveToinvestigatetheclinicaloutcomeofmet
5、hylprednisolonecombinedwithorbitalradiotherapyforthetreatmentofmoderate—to—severeGravesophthalmopathy．MethodsNinetypatientswithmoderate—to—severeGravesophthalmopathyweredividedintothreegroupsaccordingtothetherapiestheyreceived．Thirty—fivecasesinthecontrolgroupreceiveda
6、ntithyroiddrugtherapy，32casesintheglucocorticoidgroupweretreatedwithmethylprednisolone，and23casesinthecombinationgroupweregivenmethylprednisolonepulseorbitalradiotherapy．Thedegreeofexophthalmosandclinicalactivityscore(CAS)wereobservedbeforeandaftertreatmentintwogroups．
7、Pa~sultsNoseveresideefectswereobservedinallpatientsduringtreatment．Thecombinationgroupandglucocorticoidgroupshowedbetterefectscomparedwithcontrolgroup(尸<0．05)，andthecombinationgroupshowedbettereffectscomparedwithglucocorticoidgroup(P<0．05)．ThedegreesofexophthalmosandCA
8、Sscoresaftertreatmentweresignificantlylowerthanthosebeforetreatmentinthethreegroups(P<0．05)，thedecreasewaslargestinth
