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目的:观察国产氯喹用于内分泌突眼的临床治疗效果,同时与强的松治疗组对照,在疗效及副反应上有何特点与不同。方法:我院经甲状腺功能检查及眼科检查诊断为内分泌突眼病人及 Grave’s 甲亢伴Ⅲ度以上突眼病人86例。眼突度改变按美国甲状腺学会分类,按就诊日期随机分为两组,氯喹组46例,强的松组40例。两组病人在年龄、性别、病情程度及病程上均无明显差异。氯喹组采用他巴唑5～30mg/日,控制患者甲亢症状并调节免疫功能,每晚口服氯喹0.25g 一片。强的松组每日口服强的松30mg,疗程为3～6月。每月观察甲状腺功能及眼征。结果:两组病人在治疗3月后,突眼症状及体征均有明显好转,P<0.01,治疗6月后90%病人眼征均较治疗前下降2～3度,80%的病人眼征基本恢复正常。强的松组体重增加者占90%,2例患者因糖代谢紊乱诊断为 IGT 而改用氯喹治疗。氯喹组1例用药后头昏,改用晚上睡前服药后症状消失而能坚持用药。结论:氯喹治疗自身免疫性疾病内分泌突眼,有疗效显著,用药方便、安全、经济,副作用小,病人依从性好的特点。可以作为治疗内分沁突眼的又一有效、安全的选择。
Objective: To observe the curative effect of domestic chloroquine used for endocrine exophthalmos, and compare with the prednisone treatment group, what are the characteristics and differences in curative effect and side reaction. Methods: 86 cases of endocrine exophthalmos patients and Grave’s hyperthyroidism patients with Ⅲ degree or more of exophthalmos were diagnosed by thyroid function test and ophthalmology examination in our hospital. According to the American Thyroid Association classification, according to the date of treatment, 46 eyes were divided into two groups: chloroquine group (46 cases) and prednisone group (40 cases). There was no significant difference between the two groups in terms of age, sex, severity of illness and course of disease. Chloroquine group methimazole 5 ~ 30mg / day, control of patients with hyperthyroidism symptoms and regulate immune function, a night oral chloroquine 0.25g. Prednisone daily oral prednisone 30mg, treatment for 3 to 6 months. Observation of thyroid function and eye sign every month. Results: After 3 months treatment, the symptoms and signs of exophthalmos in both groups were significantly improved (P <0.01). After 6 months of treatment, the eye sign of 90% patients decreased by 2 ~ 3 degrees compared with that before treatment and the eye sign of 80% of patients The basic return to normal. Prednisone group accounted for 90% of body weight gain, 2 patients diagnosed with IGT due to glucose metabolism disorder instead of chloroquine treatment. Chloroquine group 1 dizziness after treatment, switch to the night before going to bed to relieve symptoms and medication can adhere to medication. Conclusion: Chloroquine is an endocrine exacerbation of autoimmune diseases with significant curative effect, convenient administration, safety, economy, small side effects and good patient compliance. It can be used as an effective and safe alternative for the treatment of internal pests.