| Purpose:Thyroid-associated ophthalmopathy(TAO)is an autoimmune disease related to various thyroid conditions.The incidence rate of TAO is the highest among the adult orbital diseases.The changes of living environment and the increasing pressure of life lead to the disorder of the immune system and the increasing of TAO.At the same time,TAO affects the appearance and vision patients.Its pathogenesis is not completely understood.Although the clinical treatment means are various,there is no effective treatment plan.This study is aim to explore the clinical characteristics,the abnormal situation of thyroid function 'and related antibodies,and the severity of the disease,to explore the relationship of sex,age,course of disease,smoking,and the development of TAO and the clinical efficacy of different treatment methods for TAO patients with long-term clinical evaluation.Methods:A retrospective study included 57 hospitalized cases from September 2014 to August 2009 in the department of endocrinology,the first affiliated hospital of Zhejiang university.The Clinical characteristics of the disease,thyroid function,thyroid antibody positive rate,EUGOGO severity were analyzed.Comparison of data of different gender,age,course of disease,whether smoking of CAS score,NOSPECS grade,OI score was carried out.The 44 cases in different treatment of TAO were divided into 5 groups,GC+ radiotherapy group,GC group,ATDS group,1311 group,no treatment group,through the assessment before and after the treatment,according to the degree of exophthalmos change and the symptoms and signs of judgment,to assess the clinical efficacy.Results:In the 57 cases of TAO,hyperthyroidism patients accounted for 96.49%,subclinical hyperthyroidism and hypothyroidism respectively accounted for 1.75%.In the patients with hyperthyroidism.Early onset of the diagnosis of hyperthyroidism accounted for 10.91%,at the same time for 40%,and the later for 49.09%.Monocular incidence accounted for 5.26%,binocular for 94.73%.Clinical manifestations in eyelid retraction,soft tissue involvement,exophthalmos had the highest incidence,respectively 96.49%,80.70%and 77.19%;hospitalized cases EUGOGO severity assessment to severe,the majority of patients accounted for 22.81%.The proportion of male and female was 1.19:1 in 57 cases,which was not in conformity with other epidemiological characters,which might be related to the sample size.The CAS score,NOSPECS grade and OI score of patients with TAO were positively correlated with the age of the patients(P<0.05 or P<0.01),and the course of disease was negatively correlated with CAS score,NOSPECS grade and OI score(P<0.01),and the CAS score and OI score of patients with TAO were positively correlated with the smoking factor of the patients(P<0.05).Gender factor with CAS score,NOSPECS grade and OI score,age with NOSPECS grade,smoking with NOSPECS grade and the course with NOSPECS grade,OI score were not correlated(P>0.05).The effective rate of GC + radiotherapy was 100%,the GC was 50%,the ATDs was 41.18%,the 131I was 75%,and the no treatment group was 25%,the curative effect of the GC + radiotherapy group is more ideal.Conclusion:This clinical observation found that all the thyroid function of TAO patients had different degrees abnormal manifestation,binocular incidence dominated.The main clinical manifestations were eyelid retraction,soft tissue involvement and exophthalmos mainly.EUGOGO severity assessment to severe patients are in the majority.Age was positively correlated with clinical activity and severity in patients with TAO(P<0.05 or P<0.01),and the course of disease was negatively correlated with the clinical activity and severity of patients(P<0.01),and the smoking factor was positively correlated with clinical activity and severity in patients with TAO(P<0.05).Gender factor with clinical activity and severity were not correlated(P?0.05).The treatment of glucocorticoids receptor with radiotherapy is more ideal.it can be used as the first choice for clinical treatment of moderate and severe thyroid TAO. |
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