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目的观察99锝-亚甲基二膦酸盐注射液(99 Tc-MDP,商品名:云克)联合甲泼尼龙琥珀酸钠粉针治疗甲状腺相关眼病(TAO)的疗效。方法将病程都在1年以内的42例TAO患者随机分为2组:实验组应用99 Tc-MDP联合甲泼尼龙琥珀酸钠粉针冲击治疗,口服泼尼松片40mg/d,1个月后停药;对照组应用甲泼尼龙琥珀酸钠粉针冲击治疗,口服泼尼松片40mg/d,4个月后停药。评价治疗前后两组患者的突眼度及TAO眼病活动性,并进行组间比较。结果两组TAO的临床症状均有改善,其中在突眼度方面,实验组有效率为90.9%(20/22),对照组有效率为65%(13/20),两组差异有统计学意义(P<0.05)。而两组TAO眼病活动性治疗效果比较,差异无统计学意义(P>0.05)。实验组未出现与99 Tc-MDP有关的不良反应。结论 99 Tc-MDP联合甲泼尼龙治疗甲状腺相关眼病在突眼度的改善方面具有较好的疗效,无明显不良反应,同时缩短了糖皮质激素的使用疗程。
Objective To observe the therapeutic effect of 99 Tc-methylene diphosphonate (99 Tc-MDP, trade name: Yunke) combined with methylprednisolone sodium succinate on the treatment of thyroid associated ophthalmopathy (TAO). Methods 42 patients with TAO within one year course were randomly divided into two groups: experimental group received 99 Tc-MDP combined with methylprednisolone sodium succinate powder injection therapy, oral prednisone 40mg / d, 1 month After discontinuation, the control group was treated with methylprednisolone sodium succinate injection and 40 mg / d prednisone for 4 months. The degree of exophthalmos and the activity of TAO ophthalmopathy in both groups before and after treatment were evaluated and compared between groups. Results The clinical symptoms of TAO were improved in both groups. The effective rate was 90.9% (20/22) in the experimental group and 65% (13/20) in the control group, the difference was statistically significant Significance (P <0.05). The TAO ophthalmic active treatment in both groups, the difference was not statistically significant (P> 0.05). The experimental group did not appear and 99Tc-MDP-related adverse reactions. Conclusion 99Tc-MDP combined with methylprednisolone treatment of thyroid-related ophthalmopathy in the improvement of the degree of exophthalmos has a good effect, no significant adverse reactions, while reducing the use of glucocorticoid treatment.