Pilarska K, Czekalski S, Syrenicz A, Andrzejewska W, Krzystolik Z, Przerwa D
Kliniki Endokrynologii i Chorób Przemiany Materii, Szczecinie.
Pol Tyg Lek. 1992;47(44-45):1000-3.
The early (immediately after the end of treatment) and late (from 12 to 91, mean 46.3 months after the end of treatment) results of progressive Graves-Basedow ophthalmopathy treatment were evaluated in 71 patients (57 women and 14 men, aged 25-66, mean 47.3 years). In all patients the thorough ophthalmological evaluation was performed early and late after treatment and the abnormalities found were classified according to Werner's method and Donaldson's ophthalmopathy index. The patients were divided into 7 groups according to different methods of treatment. Groups I-V consisted of 31 patients treated with glucocorticoids or glucocorticoids with azathioprine (Imuran) in the first stage of medication (30 patients). Plasmapheresis (7 patients) or tele-cobalt irradiation (3 patients) was applied as the second stage of treatment when the first stage was ineffective. In one person plasmapheresis and tele-cobalt irradiation was applied without previous glucocorticoid therapy. Two patients were treated successively by glucocorticoids, plasmapheresis and tele-cobalt irradiation. Very good and good late results of treatment were found in 95% of patients out of 22 reexamined persons of groups 1-5. Group 6 consisted of 7 patients treated with cobalt irradiation alone, in all 6 patients evaluated late results were good or very good. Out of 33 patients of group 7 treated by combination of glucocorticoids and telecobalt irradiation 23 were evaluated late and the results were found good or very good in 96%. The results suggest that combined treatment of progressive endocrine ophthalmopathy with glucocorticoids and cobalt irradiation is the most effective method of treatment at present. The affectivity of stage treatment is comparable with combined treatment but lasts longer and usually is more expansive.(ABSTRACT TRUNCATED AT 250 WORDS)
对71例患者(57名女性和14名男性,年龄25 - 66岁,平均47.3岁)进行了Graves - 巴塞多氏眼病(突眼性甲状腺肿)进行性治疗的早期(治疗结束后立即)和晚期(治疗结束后12至91个月,平均46.3个月)结果评估。所有患者在治疗的早期和晚期均进行了全面的眼科评估,并根据维尔纳方法和唐纳森眼病指数对发现的异常进行分类。根据不同的治疗方法将患者分为7组。第一至五组由31例患者组成,这些患者在药物治疗的第一阶段接受了糖皮质激素或糖皮质激素与硫唑嘌呤(依木兰)联合治疗(30例患者)。当第一阶段治疗无效时,采用血浆置换(7例患者)或远距离钴照射(3例患者)作为第二阶段治疗。有1例患者在未进行糖皮质激素治疗之前就采用了血浆置换和远距离钴照射。2例患者先后接受了糖皮质激素、血浆置换和远距离钴照射治疗。在第1 - 5组重新检查的22例患者中,95%的患者治疗晚期结果为非常好或良好。第6组由7例仅接受钴照射治疗的患者组成,在所有6例接受晚期评估的患者中,结果为良好或非常好。在第7组的33例接受糖皮质激素和远距离钴照射联合治疗的患者中,23例接受了晚期评估,96%的结果为良好或非常好。结果表明,糖皮质激素和钴照射联合治疗进行性内分泌眼病是目前最有效的治疗方法。阶段治疗的有效性与联合治疗相当,但持续时间更长,通常费用更高。(摘要截取自250字)