合并糖尿病的Graves眼病的治疗及疗效观察
Treatment and Curative Effect of Graves Ophthalmopathy Complicated with Diabetes Mellitus
DOI: 10.12677/ACM.2022.1281034, PDF,   
作者: 崔 颖*：潍坊医学院临床医学院，山东 潍坊；潘振宇*：山东医学高等专科学校，山东 临沂；高冠起：临沂市人民医院内分泌与代谢病科，山东 临沂
关键词: 糖尿病；Graves眼病；内分泌疾病；临床效果；Diabetes； Graves Ophthalmopathy； Endocrine Diseases； Clinical Effect
摘要: 目的：探究对合并糖尿病的Graves眼病进行治疗的方法及临床效果。方法：选取于2016年10月至2022年04月临沂市人民医院收治的130例合并糖尿病的Graves眼病患者，随机分为观察组(甲强龙联合甲氨蝶呤治疗)和对照组(甲强龙治疗)各65人。对比两组治疗情况。结果：相比于对照组(78.46%)，观察组治疗总有效率(96.92%)较高(P < 0.05)；观察组、对照组治疗后的血糖水平均下降，差异有统计学意义(P < 0.05)，但治疗后血糖值组间差异无统计学意义(P > 0.05)；观察组临床症状评分低于对照组(P < 0.05)；结论：对合并糖尿病的Graves眼病患者运用甲强龙联合甲氨蝶呤治疗，能够提高治疗的疗效，减轻患者临床症状，使其生活质量得到改善。
Abstract: Objective: To explore the treatment method and clinical effect of Graves eye disease with diabetes mellitus. Methods: A total of 130 patients with Graves’ disease complicated with diabetes who were admitted to Linyi People’s Hospital from October 2016 to April 2022 were randomly divided into observation group (methylprednone plus methotrexate treatment) and control group (methylprednone treatment), 65 in each group. The treatment of the two groups was compared. Results: Compared with the control group (78.46%), the total effective rate of observation group (96.92%) was higher (P < 0.05). The blood glucose level of the observation group and the control group decreased after treatment, and the difference was statistically significant (P < 0.05), but there was no significant difference in blood glucose value between the two groups after treatment (P > 0.05). The clinical symptom score of observation group was lower than that of control group (P < 0.05). Conclusion: The use of methylprednone combined with methotrexate in the treatment of Graves eye disease patients with diabetes can improve the therapeutic effect, relieve the clinical symptoms and improve their quality of life.
文章引用：崔颖, 潘振宇, 高冠起. 合并糖尿病的Graves眼病的治疗及疗效观察[J]. 临床医学进展, 2022, 12(8): 7166-7171. https://doi.org/10.12677/ACM.2022.1281034

参考文献

[1] Ross, D.S., Burch, H.B., Cooper, D.S., et al. (2016) 2016 American Thyroid Association Guidelines for Diagnosis and Management of Hyperthyroidism and Other Causes of Thyrotoxicosis. Thyroid, 26, 1343-1421. [Google Scholar] [CrossRef] [PubMed]
[2] 张俐. 甲状腺激素水平与糖尿病的关系[J]. 中国老年保健医学, 2013, 11(1): 19.
[3] 张志永, 张喜平. 糖尿病病人患甲状腺疾病的相关因素分析[J]. 内蒙古医科大学学报, 2016, 38(4): 346-347, 350.
[4] 陈丽娜. 合并糖尿病的毒性甲状腺肿患者内分泌疾病的治疗措施[J]. 中国保健营养, 2020, 30(13): 141.
[5] Bartalena, L., Kahaly, G.J., Baldeschi, L., et al. (2021) The 2021 European Group on Graves’ Orbitopathy (EUGOGO) Clinical Practice Guidelines for the Medical Management of Graves’ Orbitopathy. European Journal of Endocrinology, 185, G43-G67. [Google Scholar] [CrossRef] 
[6] Association A D (2020) 2. Classification and Diagnosis of Diabetes: Standards of Medical Care in Diabetes—2020. Diabetes Care, 43, S14-S31. [Google Scholar] [CrossRef] 
[7] 陈灏珠, 钟南山, 陆再英(主审), 葛均波, 徐永健, 王辰(主编), 唐承薇, 周晋, 肖海鹏, 王建安, 曾小峰(副主编). 内科学[M]. 第9版. 北京: 人民卫生出版社, 2018: 942.
[8] 曾鹏, 余韵, 范淑贤, 等. 甲状腺相关眼病的EUGOGO临床分级特征[J]. 中山大学学报(医学科学版), 2018, 39(6): 884-890.
[9] 甲氨蝶呤治疗银屑病应用专家共识[J]. 临床皮肤科杂志, 2022, 51(2): 108-117.
[10] Barwinek, K., Gąsior-Perczak, D., Trepka, S., et al. (2020) Effective Preoperative Plasmapheresis Treatment of Severe Hyperthyroidism in a Patient with Giant Toxic Nodular Goiter and Methimazole-Induced Agranulocytosis. Medicina, 56, 290. [Google Scholar] [CrossRef] [PubMed]
[11] 任秀莲, 薛元明. 糖尿病合并甲状腺疾病的研究进展[J]. 药品评价, 2011, 8(19): 37-39.
[12] 黄汉乔. 合并糖尿病的毒性甲状腺肿患者内分泌疾病的治疗[J]. 国际医药卫生导报, 2018, 24(8): 1240-1242.
[13] Kahaly, G.J., Pitz, S., Hommel, G., et al. (2005) Randomized, Single Blind Trial of Intravenous Versus Oral Steroid Monotherapy in Graves’ Orbitopathy. The Journal of Clinical Endocrinology & Metab-olism, 90, 5234-5240. [Google Scholar] [CrossRef] [PubMed]
[14] 李爱玲. 合并糖尿病的中重度grave眼病的相关治疗分析[J]. 医学食疗与健康, 2021, 19(5): 54-55.
[15] 向光大. 临床甲状腺病学[J]. 中国医刊, 2014(49): 112.
[16] Sipkova, Z., In-sull, E.A., David, J., et al. (2018) Early Use of Steroid-Sparing Agents in the Inactivation of Moderate-to-Severe Active Thyroid Eye Disease: A Step-Down Approach. Clinical Endocrinology, 89, 834-839. [Google Scholar] [CrossRef] [PubMed]
[17] Seitz, M. (1999) Molecular and Cellular Effects of Methotrexate. Current Opinion in Rheumatology, 11, 226-232. [Google Scholar] [CrossRef] [PubMed]
[18] 蔡阳, 叶梅. 甲氨蝶呤治疗类风湿关节炎的常见不良反应分析[J]. 中国药物滥用防治杂志, 2021, 27(3): 345-348.
[19] 刘婷娜. 糖尿病合并毒性甲状腺肿患者相关内分泌疾病治疗方法[J]. 世界最新医学信息文摘, 2019, 19(66): 193+195.
[20] Strianese, D., Iuliano, A., Ferrara, M., et al. (2014) Methotrexate for the Treatment of Thyroid Eye Disease. Journal of Ophthalmology, 2014, Article ID: 128903. [Google Scholar] [CrossRef] [PubMed]
[21] 宋效成, 邱瑞桂, 黄斌, 等. 甲氨蝶呤片联合甲基强的松龙治疗Graves眼病临床疗效观察[J]. 内科, 2016, 11(6): 907-909.

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