Perros Petros, Žarković Miloš, Azzolini Claudio, Ayvaz Göksun, Baldeschi Lelio, Bartalena Luigi, Boschi Antonella, Bournaud Claire, Brix Thomas Heiberg, Covelli Danila, Ćirić Slavica, Daumerie Chantal, Eckstein Anja, Fichter Nicole, Führer Dagmar, Hegedüs Laszlo, Kahaly George J, Konuk Onur, Lareida Jürg, Lazarus John, Leo Marenza, Mathiopoulou Lemonia, Menconi Francesca, Morris Daniel, Okosieme Onyebuchi, Orgiazzi Jaques, Pitz Susanne, Salvi Mario, Vardanian-Vartin Cristina, Wiersinga Wilmar, Bernard Martine, Clarke Lucy, Currò Nicola, Dayan Colin, Dickinson Jane, Knežević Miroslav, Lane Carol, Marcocci Claudio, Marinò Michele, Möller Lars, Nardi Marco, Neoh Christopher, Pearce Simon, von Arx George, Törüner Fosun Baloş
Department of Endocrinology, Institute of Genetic Medicine, Newcastle University, Newcastle upon Tyne, UK.
Department of Endocrinology, School of Medicine, University of Belgrade, Belgrade, Serbia.
Br J Ophthalmol. 2015 Nov;99(11):1531-5. doi: 10.1136/bjophthalmol-2015-306733. Epub 2015 May 7.
BACKGROUND/AIMS: The epidemiology of Graves' orbitopathy (GO) may be changing. The aim of the study was to identify trends in presentation of GO to tertiary centres and initial management over time.
Prospective observational study of European Group On Graves' Orbitopathy (EUGOGO) centres. All new referrals with a diagnosis of GO over a 4-month period in 2012 were included. Clinical and demographic characteristics, referral timelines and initial decisions about management were recorded. The data were compared with a similar EUGOGO survey performed in 2000.
The demographic characteristics of 269 patients studied in 2012 were similar to those collected in the year 2000, including smoking rates (40.0% vs 40.2%). Mild (60.5% vs 41.2%, p<0.01) and inactive GO (63.2% vs 39.9%, p<0.01) were more prevalent in 2012. The times from diagnosis of thyroid disease to being seen in EUGOGO centres (6 vs 16 months) and from first symptoms of GO (9 vs 16 months) or from diagnosis of GO (6 vs 12 months) to first consultation in EUGOGO centres were shorter in 2012 (p<0.01). The initial management plans for GO were no different except surgical treatments for patients with mild inactive disease were more frequently offered in the 2012 cohort than in 2000 (27.3% vs 17%, p<0.05), and selenium supplements were offered only in the 2012 cohort (21.2% vs 0%, p<0.01).
These findings suggest that the clinical manifestations of patients with GO may be changing over time in Europe.
背景/目的：格雷夫斯眼眶病（GO）的流行病学情况可能正在发生变化。本研究旨在确定GO患者在三级医疗中心的就诊趋势以及随时间推移的初始治疗情况。
对欧洲格雷夫斯眼眶病研究组（EUGOGO）中心进行前瞻性观察研究。纳入2012年4个月内所有新确诊为GO的转诊患者。记录临床和人口统计学特征、转诊时间线以及关于治疗的初始决策。将这些数据与2000年进行的一项类似的EUGOGO调查进行比较。
2012年研究的269例患者的人口统计学特征与2000年收集的相似，包括吸烟率（40.0%对40.2%）。2012年轻度GO（60.5%对41.2%，p<0.01）和静止期GO（63.2%对39.9%，p<0.01）更为常见。2012年从甲状腺疾病诊断到在EUGOGO中心就诊的时间（6个月对16个月）以及从GO的首发症状（9个月对16个月）或GO诊断（6个月对12个月）到在EUGOGO中心首次咨询的时间更短（p<0.01）。GO的初始治疗方案没有差异，只是2012年队列中对轻度静止期疾病患者进行手术治疗的频率高于2000年（27.3%对17%，p<0.05），并且仅在2012年队列中提供了硒补充剂（21.2%对0%，p<0.01）。
这些发现表明，在欧洲，GO患者的临床表现可能随时间而变化。
