Graves病患者眼部临床表现及其伴眼球突出者血清FT3,FT4,TSH,TPOAb检测的临床意义
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Clinical significance of determination of sera FT3,FT4,TSH,TPOAb in exophthalmos patients with Graves’ disease
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    摘要:

    目的:总结分析Graves病患者出现眼球突出、眼睑退缩、眼睑闭合不全、眼睑肿胀、球结膜充血及水肿及眼球运动障碍等临床体征的分布状况;探讨FT3,FT4,TSH,TPOAb在Graves病(GD)伴眼球突出患者发病中的作用。方法:收集分析207例预行放射性碘治疗的GD患者眼部体征;采用放射免疫分析法检测125例GD伴眼球突出患者,82例GD患者血清FT3,FT4,TSH,TPOAb值,并对两组各指标的检测值进行比较。结果:患者207例发生眼球突出125例(60.4%),眼睑退缩169例(81.6%),眼睑迟落152例(73.4%),眼睑闭合不全176例(85.0%),眼睑肿胀88例(42.5%),球结膜充血及水肿92例(44.4%);眼球运动障碍者16例(7.7%),角膜水肿或溃疡3例(1.4%);两组患者间血清FT3,FT4,TSH,TPOAb值差异无显著意义(P>0.05)。结论:两组患者甲状腺均呈高分泌状态;85%以上的GD患者有不同程度的眼部表现,对于适合接受放射性碘治疗的GD患者,眼病的诊治不容忽视。

    Abstract:

    AIM:To investigate the value of sera FT3,FT4,TSH,TPOAb in exophthalmos patients with Graves’ disease(GD);and to summarize and analyze the topography of the clinical manifestation of GD,such as exophthalmos,lid retraction and lid fullness,hypophasis,hyperremia and edema of conjunctiva,disorder of ocular movement and so on. ·METHODS:The clinical manifestations of 207 patients with GD who underwent radioiodine therapy were collected and analyzed,and sera FT3,FT4,TSH,TPOAb levels were measured and compared in patients with GD and exophthalmos (n=125) and GD patients(n=82). ·RESULTS:Exophthalmos were present in 125 cases (60.4%);lid retraction in 169 cases (81.6%);hypophasis in 176 cases(85.0%),lid fullness in 88 cases (42.5%);hyperremia and edema of conjunctiva in 92 cases(44.4%);disorder of ocular movement in 16 cases(7.7%); corneal edema or ulcer in 3 cases(1.4%);sera FT3,FT4,TSH,TPOAb levels in two groups had no significant difference(P>0.05). ·CONCLUSION:Both groups are all in high secretor state; different ocular manifestations are present in over 85% patients. Diagnosis and treatment of thyroid-associated ophthalmopathy(TAO) can’t be ignored.

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易湘龙. Graves病患者眼部临床表现及其伴眼球突出者血清FT3,FT4,TSH, TPOAb检测的临床意义.国际眼科杂志, 2010,10(9):1710-1712.

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