Mazurov V I, Sviatova L E, Danilichev V F, Cheremisin V M, Gurevich K Ia
Probl Endokrinol (Mosk). 1993 Jan-Feb;39(1):24-7.
The results of comprehensive examinations and therapy of 67 patients with autoimmune ophthalmopathy are presented. In 80% of the patients the disease coursed along with thyrotoxicosis, in 10% thyroid function was reduced because of autoimmune thyroiditis, and in the rest autoimmune ophthalmopathy was an individual entity. A staged therapeutic complex for the treatment of this condition is suggested, aimed at correction of thyroid function (stage 1), followed by pathogenetic therapy including antiinflammatory measures, glucocorticoids and nonsteroid antiinflammatory drugs to arrest aseptic inflammation in the orbit, and immunosuppressive therapy to correct the immunity shifts. After clinical and immunologic remission was achieved, courses of maintenance therapy (nonsteroid antiinflammatory drugs) were carried out for 3-5 months monitored by blood analyses and ophthalmologic examinations, immunity status tests, CT clinical data. Choice of the treatment strategy was governed by the morphologic variant of ophthalmopathy, immunologic activity of the process, disease severity and pattern. Such an approach helped achieve positive results and clinico-immunologic remission, as well as timely prevent the progress of the disease.
本文介绍了67例自身免疫性眼病患者的综合检查及治疗结果。80%的患者病情与甲状腺毒症同时发生，10%的患者因自身免疫性甲状腺炎导致甲状腺功能减退，其余患者的自身免疫性眼病为独立病症。本文提出了一种针对该病症的分阶段治疗方案，旨在纠正甲状腺功能（第1阶段），随后进行病因治疗，包括抗炎措施、糖皮质激素和非甾体抗炎药以抑制眼眶无菌性炎症，以及免疫抑制治疗以纠正免疫失衡。在实现临床和免疫缓解后，进行为期3至5个月的维持治疗（使用非甾体抗炎药），并通过血液分析、眼科检查、免疫状态测试和CT临床数据进行监测。治疗策略的选择取决于眼病的形态学变异、疾病进程的免疫活性、疾病严重程度和模式。这种方法有助于取得积极的治疗效果并实现临床免疫缓解，同时及时预防疾病进展。
