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探讨Graves眼病(GO)患者外周血细胞因子水平及雷公藤多苷干预的影响。选择64例中重度急性期GO患者。随机分为治疗组与对照组各32例。2组均行基础治疗,对照组联合强的松0.75 mg·kg-1·d-1,逐渐减量(5~10 mg/周),至最小剂量5 mg·d-1。治疗组联合雷公藤多苷20 mg/次,每天3次口服。3个月为1疗程。观察2组治疗前后外周血细胞因子(TNF-α,IL-2,IL-10,IFN-γ)水平及临床疗效。研究表明2组治疗前TNF-α,IL-2,IFN-γ明显高于健康组,IL-10明显低于健康组。治疗后治疗组TNF-α,IL-2,IFN-γ明显降低,而IL-10明显增高(P<0.01),治疗后2组比较差异有显著性(P<0.01);临床总有效率治疗组88.10%;对照组57.14%(P<0.01)2组比较差异有显著性;2组治疗后眼球突出度检测比有显著性差异(P<0.01)。结果提示GO患者外周血细胞因子(TNF-α,IL-2,IFN-γ)水平与眼病严重程度呈正相关。雷公藤多苷联合他巴唑治疗GO,具有副作用小、疗效满意等优点。
To investigate the effect of Tripterygium glycosides on peripheral blood cytokines in patients with Graves ophthalmopathy (GO). Choose 64 cases of moderate and severe acute GO patients. Randomly divided into treatment group and control group of 32 cases. The patients in both groups were given basic treatment. The control group was given prednisone (0.75 mg · kg -1 · d -1), tapering (5 ~ 10 mg / week) to the minimum dose of 5 mg · d -1. The treatment group combined Tripterygium glycosides 20 mg / time, 3 times a day orally. 3 months for a course of treatment. The levels of peripheral blood cytokines (TNF-α, IL-2, IL-10, IFN-γ) and their clinical effects in two groups before and after treatment were observed. Studies have shown that the two groups before treatment TNF-α, IL-2, IFN-γ was significantly higher than the healthy group, IL-10 was significantly lower than the healthy group. After treatment, the levels of TNF-α, IL-2 and IFN-γ in the treatment group were significantly decreased, while IL-10 was significantly increased (P <0.01) 88.10% in the control group; 57.14% in the control group (P <0.01). There was a significant difference between the two groups (P <0.01). The results suggest that GO patients with peripheral blood cytokines (TNF-α, IL-2, IFN-γ) levels and the severity of eye disease was positively correlated. Tripterygium glycosides combined with methimazole treatment of GO, with little side effects, efficacy and other advantages.