Hoppe Elena, Lee Alan Chun Hong, Hoppe David, Kahaly George J
Department of Medicine I, Johannes Gutenberg University Medical Center, Mainz, Germany.
Department of Paediatrics, Johannes Gutenberg University Medical Center, Mainz, Germany.
Eur Thyroid J. 2021 Feb;9(6):313-320. doi: 10.1159/000508071. Epub 2020 Jul 2.
To investigate the predictive factors for changes in the quality of life (GO-QoL) of patients with Graves' orbitopathy (GO) prior to and after specific treatment.
A prospective follow-up study was conducted at an academic tertiary referral orbital center with a joint thyroid-eye clinic on 100 consecutive patients with GO. Before and after the standard 12-week course of weekly intravenous methylprednisolone (cumulative dose 4.5 g), the GO-QoL questionnaire provided by the European Group on Graves' Orbitopathy (EUGOGO) was completed. Endocrine and ophthalmic assessments were performed at each visit.
All patients were biochemically euthyroid and untreated for GO at baseline and presented with active and moderate-to-severe disease. Both GO-QoL subscales (visual functioning [VF] and appearance [AP]) significantly increased after immunosuppressive therapy and showed a sustained improvement for 6 months. At baseline, demographic variables (sex, age, and smoking) influenced QoL in the stepwise linear regression ( < 0.01, adjusted = 0.24 for VF and < 0.01, adjusted = 0.21 for AP). In contrast, 6 months after treatment, the improved QoL was now exclusively associated with ophthalmic parameters ( < 0.01, adjusted = 0.47 for VF; < 0.01, adjusted = 0.23 for AP).
Predictive factors for GO-QoL differed not only between the 2 subscales but also before and after the first treatment of GO.
研究格雷夫斯眼眶病（GO）患者在特定治疗前后生活质量变化（GO-QoL）的预测因素。
在一家学术性三级转诊眼眶中心与甲状腺-眼科联合诊所对100例连续的GO患者进行前瞻性随访研究。在每周静脉注射甲泼尼龙标准12周疗程（累积剂量4.5 g）前后，完成欧洲格雷夫斯眼眶病专家组（EUGOGO）提供的GO-QoL问卷。每次就诊时进行内分泌和眼科评估。
所有患者在基线时生化指标甲状腺功能正常且未接受GO治疗，表现为活动性中重度疾病。免疫抑制治疗后，GO-QoL的两个子量表（视觉功能[VF]和外观[AP]）均显著提高，并在6个月内持续改善。在基线时，人口统计学变量（性别、年龄和吸烟）在逐步线性回归中影响生活质量（VF：<0.01，调整后R² = 0.24；AP：<0.01，调整后R² = 0.21）。相比之下，治疗6个月后，改善的生活质量仅与眼科参数相关（VF：<0.01，调整后R² = 0.47；AP：<0.01，调整后R² = 0.23）。
GO-QoL的预测因素不仅在两个子量表之间不同，而且在GO首次治疗前后也不同。
