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利妥昔单抗联合¹³¹I对格雷夫斯眼病患者眼科结局的疗效

The Efficacy of Rituximab Combined with 131I for Ophthalmic Outcomes of Graves' Ophthalmopathy Patients.

作者信息

Li Jiagen, Xiao Zhangsheng, Hu Xianjie, Li Yun, Zhang Xing, Zhang Songze, Gong Weikun, Zhao Jianqiang, Ye Xuemei

机构信息

Department of Thyroid Breast Surgery, Yinzhou Hospital of Ningbo University Medical College, Ningbo, China.

出版信息

Pharmacology. 2017;99(3-4):144-152. doi: 10.1159/000453618. Epub 2017 Jan 4.

Abstract

PURPOSE

The purpose of this study is to examine the effectiveness of introducing both rituximab (RTX) and 131I for active Graves' ophthalmopathy (GO) with hyperthyroidism.

METHODS

In total, 217 patients suffering from active GO with hyperthyroidism were included in this research. All subjects were randomly assigned to 3 groups. Patients in group A solely received 131I treatment; group B1 underwent a methylprednisolone treatment in combination with 131I treatment; and group B2 received an RTX in combination with 131I treatment. Hyperthyroidism treatment outcomes, orbital volumetry, ophthalmic assessments, serum cytokine levels, and adverse effects were measured after treatment.

RESULTS

The orbital volumetry principle was significantly different from 24 weeks after the start of treatment among all 3 groups, and improvements in most ophthalmic parameters were regarded significantly different among 3 groups (all p < 0.05). The expression levels of miR-146a and most serum cytokines were regarded significantly different from 24 weeks after the start of treatment among 3 groups (all p < 0.05).

CONCLUSIONS

In comparison with other therapies, RTX treatment in combination with 131I treatment is considered to be more effective for hyperthyroidism with active GO.

摘要

目的

本研究旨在探讨利妥昔单抗(RTX)联合¹³¹I治疗伴有甲状腺功能亢进的活动性格雷夫斯眼病(GO)的有效性。

方法

本研究共纳入217例伴有甲状腺功能亢进的活动性GO患者。所有受试者随机分为3组。A组患者仅接受¹³¹I治疗;B1组接受甲泼尼龙联合¹³¹I治疗;B2组接受RTX联合¹³¹I治疗。治疗后测量甲状腺功能亢进治疗效果、眼眶容积测量、眼科评估、血清细胞因子水平及不良反应。

结果

治疗开始24周后,所有3组的眼眶容积测量指标均有显著差异,且3组大多数眼科参数的改善均有显著差异(均p < 0.05)。3组治疗开始24周后,miR-146a和大多数血清细胞因子的表达水平均有显著差异(均p < 0.05)。

结论

与其他治疗方法相比,RTX联合¹³¹I治疗伴有活动性GO的甲状腺功能亢进更为有效。

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