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[格雷夫斯眼眶病的药物治疗与放射治疗]

[Drug therapy and radiotherapy in Graves' orbitopathy].

作者信息

Beisse F, Lagrèze W A, Schmucker M

机构信息

Universitäts-Augenklinik Freiburg, Killianstr., Deutschland.

出版信息

Ophthalmologe. 2011 May;108(5):425-31. doi: 10.1007/s00347-010-2187-7.

DOI:10.1007/s00347-010-2187-7
PMID:21590352
Abstract

Drug therapy and radiotherapy in Graves' orbitopathy (GO) aim mainly at the inherent soft tissue inflammation. A timely and sustained anti-inflammatory therapy not only alleviates the current symptoms but particularly intends to limit the degree of permanent alterations. It is indicated in active GO of moderate or higher severity. Pharmacologically, glucocorticoids and if appropriate other immunosuppressive agents, such as cyclosporine are given. Adverse effects can complicate the treatment. Retrobulbar irradiation is applied against diplopia due to eye muscle involvement during the active phase.

摘要

格雷夫斯眼眶病(GO)的药物治疗和放射治疗主要针对内在的软组织炎症。及时且持续的抗炎治疗不仅能缓解当前症状,尤其旨在限制永久性改变的程度。它适用于中重度活动性GO。在药理学上,给予糖皮质激素,如有必要,还可给予其他免疫抑制剂,如环孢素。不良反应可能使治疗复杂化。在活动期,对因眼肌受累导致的复视进行球后照射。

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本文引用的文献

1
Effect of combined intravenous glucocorticoids and orbital radiotherapy in restoring driving competency in patients with Graves' orbitopathy.静脉注射糖皮质激素联合眼眶放疗对恢复Graves眼病患者驾驶能力的影响。
Horm Metab Res. 2009 May;41(5):391-6. doi: 10.1055/s-0028-1128141. Epub 2009 Feb 4.
2
Consensus statement of the European Group on Graves' orbitopathy (EUGOGO) on management of GO.欧洲Graves眼病专家组(EUGOGO)关于Graves眼病管理的共识声明。
Eur J Endocrinol. 2008 Mar;158(3):273-85. doi: 10.1530/EJE-07-0666.
3
[Botulinum toxin treatment for crocodile tears, spastic entropion and for dysthyroid upper eyelid retraction].
肉毒杆菌毒素治疗鳄鱼泪、痉挛性睑内翻及甲状腺功能异常性上睑退缩
Ophthalmologe. 2007 Sep;104(9):771-6. doi: 10.1007/s00347-007-1592-z.
4
Radiotherapy of non-malignant disorders: where do we stand?非恶性疾病的放射治疗:我们目前的状况如何?
Radiother Oncol. 2007 May;83(2):175-7. doi: 10.1016/j.radonc.2007.04.008. Epub 2007 May 8.
5
Determinants of liver damage associated with intravenous methylprednisolone pulse therapy in Graves' ophthalmopathy.格雷夫斯眼病中与静脉注射甲泼尼龙冲击疗法相关的肝损伤的决定因素。
Thyroid. 2007 Apr;17(4):357-62. doi: 10.1089/thy.2006.0267.
6
Treatment of Graves' disease and associated ophthalmopathy with the anti-CD20 monoclonal antibody rituximab: an open study.使用抗CD20单克隆抗体利妥昔单抗治疗格雷夫斯病及相关眼病:一项开放性研究。
Eur J Endocrinol. 2007 Jan;156(1):33-40. doi: 10.1530/eje.1.02325.
7
Surgical or medical decompression as a first-line treatment of optic neuropathy in Graves' ophthalmopathy? A randomized controlled trial.手术或药物减压作为格雷夫斯眼病视神经病变的一线治疗方法?一项随机对照试验。
Clin Endocrinol (Oxf). 2005 Sep;63(3):323-8. doi: 10.1111/j.1365-2265.2005.02345.x.
8
Randomized, single blind trial of intravenous versus oral steroid monotherapy in Graves' orbitopathy.Graves眼病静脉注射与口服类固醇单药治疗的随机单盲试验。
J Clin Endocrinol Metab. 2005 Sep;90(9):5234-40. doi: 10.1210/jc.2005-0148. Epub 2005 Jul 5.
9
Double-blind, placebo-controlled trial of octreotide long-acting repeatable (LAR) in thyroid-associated ophthalmopathy.长效可重复注射用奥曲肽治疗甲状腺相关性眼病的双盲、安慰剂对照试验
J Clin Endocrinol Metab. 2004 Dec;89(12):5910-5. doi: 10.1210/jc.2004-0697.
10
The effect of etanercept on Graves' ophthalmopathy: a pilot study.依那西普对格雷夫斯眼病的影响:一项初步研究。
Eye (Lond). 2005 Dec;19(12):1286-9. doi: 10.1038/sj.eye.6701768.