Xu Shu-Hang, Li Xing-Jia, Chen Guo-Fang, Zheng Quan-Xi, Yang Yu, Hu Yong-Xin, Wang Kun, Liu Chao
Endocrine and Diabetes Center, Jiangsu Province Hospital on Integration of Chinese and Western Medicine, Nanjing University of Traditional Chinese Medicine, Jiangsu Branch of China Academy of Chinese Medical Science, Nanjing, Jiangsu, 210028, China.
Chronic Dis Transl Med. 2015 Jul 7;1(2):117-123. doi: 10.1016/j.cdtm.2015.06.001. eCollection 2015 Jun.
Management of Graves' orbitopathy (GO) continues to be a challenge to clinical endocrinologists. In the last few years, surveys on GO management have succeeded in elucidating trends in Europe and Latin America. To determine how endocrinologists in China assess and treat patients with GO and gain insight into how to make the management of this disease more uniform and standardized.
Based on the questionnaire used in the European survey on GO, a questionnaire in China was drafted and circulated to the members of Chinese Society of Endocrinology (CSE) during the annual meeting.
A total of 124 valid responses were analysed. Almost all respondents (94.4%) claimed that a multidisciplinary approach for GO management was valuable. Over 80% of the participants advocated the assessment of exophthalmometry, vision, visual fields by perimetry, eye movements, and fundoscopy. Glucocorticoids were preferred as the first-line therapy by 92.7% of respondents, among them, 59.7% choose the intravenous route. The treatment strategy for GO with intravenous glucocorticoids therapy still remains debatable. Anti-thyroid drugs (ATDs) were the most common choice (72.6%) for first-line therapy of coexisting hyperthyroidism. Treatment options for GO were very similar among Chinese, Latin-American and European respondents, whereas radioactive iodine and surgical treatment were more often indicated for co-existing hyperthyroidism in China.
The appropriate treatment for patients with GO is controversial even among thyroid specialists. Further training of thyroid specialists, easier access of patients to multidisciplinary centres and establishment of practice guidelines are required for the management of this condition in China.
格雷夫斯眼眶病（GO）的管理仍然是临床内分泌学家面临的一项挑战。在过去几年中，关于GO管理的调查成功地阐明了欧洲和拉丁美洲的趋势。旨在确定中国内分泌学家如何评估和治疗GO患者，并深入了解如何使这种疾病的管理更加统一和标准化。
基于欧洲GO调查中使用的问卷，起草了一份中国问卷，并在年会上分发给中国内分泌学会（CSE）的成员。
共分析了124份有效回复。几乎所有受访者（94.4%）都声称GO管理的多学科方法很有价值。超过80%的参与者主张对外眼测量、视力、视野计检查视野、眼球运动和眼底镜检查进行评估。92.7%的受访者首选糖皮质激素作为一线治疗，其中59.7%选择静脉途径。静脉注射糖皮质激素治疗GO的策略仍存在争议。抗甲状腺药物（ATD）是并存甲亢一线治疗最常见的选择（72.6%）。中国、拉丁美洲和欧洲受访者对GO的治疗选择非常相似，而在中国，放射性碘和手术治疗更常用于并存的甲亢。
即使在甲状腺专家中，GO患者的适当治疗也存在争议。在中国，需要对甲状腺专家进行进一步培训，使患者更容易进入多学科中心并制定实践指南来管理这种疾病。
