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霉酚酸酯治疗活动性甲状腺相关性眼病的临床疗效观察 认领 被引量:8

Mycophenolate mofetil for active thyroid-associated ophthalmopathy
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摘要 目的:目前对甲状腺相关性眼病( thyroid associated ophthalmopathy , TAO)尚无理想的治疗方法。文中比较霉酚酸酯( mycophenolate mofetil , MMF)和泼尼松对活动性TAO的安全性和疗效。方法连续收集2010年1月至2014年10月间于南京军区南京总医院门诊及住院治疗后定期随访的40例活动性TAO患者。按照不同治疗方案分为MMF组( n=22)和泼尼松组(n=18),疗程共12周。疗效评定采取临床活动性评分及TAO分级变化进行综合评定。对于治疗12周后单用泼尼松无效及眼病复发者采用MMF与泼尼松联合治疗。结果12周治疗结束时统计发现,MMF组22例患者中1例(4.5%)显效,18例(81.8%)有效,3例(13.6%)无效;泼尼松组18例患者中1例(5.6%)显效,9例(50%)有效,7例(38.9%)无效,1例(5.6%)加重。 MMF组总有效率(显效+有效)为86.4%,高于泼尼松组的55.6%(P<0.05)。治疗后2组活动度积分均较治疗前显著降低(P<0.05),下降幅度MMF组大于泼尼松组[(1.09±0.68) vs (0.67±0.91), P<0.05]。泼尼松组中3例(16.7%)胃部不适,2例(11.1%)月经紊乱;MMF组未发现不良反应者。治疗12周后发现3例单用泼尼松治疗无效者,且2组各1例的眼病复发者采用MMF与泼尼松联合治疗后突眼情况明显改善。结论新型免疫抑制剂MMF治疗TAO疗效优于泼尼松,且不良反应较少。联合治疗对单药治疗无效者及复发者有效。 Objective Up to the present time , there has been no desirable therapy for thyroid-associated ophthalmopathy ( TAO) .This study was to compare the efficacy and safety of mycophenolate mofetil ( MMF) and prednisone in the treatment of active TAO. Methods This study involved 40 cases of active TAO , which were randomly assigned to receive MMF ( n=22 ) and oral prednisone (n=18) for 12 weeks.The therapeutic results were evaluated according to the improvement in the clinical activity scores and the grades of TAO. Results By the end of the 12-week treatment, 1 (4.5%) of the 22 cases was markedly improved, 18 (81.8%) improved, and 3 (13.6%) failed to respond in the MMF group .In comparison, 1 (5.6%) of the 18 cases was markedly improved, 9 (50%) improved, 7 (38.9%) unchanged, and 1 (5.6%) aggravated in the prednisone group .The total effectiveness rate was significantly higher in the MMF than in the prednisone group (86.4%vs 55.6%, P〈0.05).The mean clinical activity score was remarkably decreased in both groups after treatment as compared with the baseline (P〈0.05), even more remarkably in the for-mer than in the latter group (1.09 ±0.68 vs 0.67 ±0.97, P〈0.05).Adverse reactions occurred in 5 cases (stomach discomfort in 3 and mild menstrual abnormality in 2) in the prednisone group , but none in the MMF group .For the 3 failed cases in the prednisone
作者 胡潇豪 叶小珍 柏晓勇 卢斌 彭丽 李洁 许一新 王燕燕 王坚 HU Xiao-hao, YE Xiao-zhen, BO Xiao-yong, LU bin, PENG Li, LI Jie, XU Yi-xin, WANG Yan-yan, WANG Jian (Department of Endocrinology, Nanjing School of Clinical Medicine, Southern Medical University/Nanjing General Hospital of Nanjing Military Region, PLA, Nanjing 210002, Jiangsu, China)
出处 《医学研究生学报》 CAS 北大核心 2015年第3期268-271,共4页 Bulletin of Medical Postgraduate
基金 国家自然科学基金(81070626) 南京军区南京总医院科研基金(2012012)
关键词 甲状腺相关性眼病 免疫治疗 霉酚酸酯 泼尼松 Thyroid associated ophthalmopathy Immunosup-pressant Mycophenolate mofetil Prednisone
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参考文献15

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二级参考文献32

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