Graves眼病的治疗进展.pdfVIP

·甲状腺疾病专栏· Graves眼病的治疗进展 崔焕焕王坚 【摘要】 Graves眼病是Graves病最重要也是最常见的一种甲状腺腺外表现。治疗前的变量，如 种族、性别、年龄、甲状腺功能、促甲状腺激素受体抗体的水平和吸烟行为会影响对治疗的反应。通 常，抗甲状腺药物和甲状腺切除术不影响Graves眼病的自然进程，而放射性碘治疗则会导致Graves 眼病的发生或进展，在很大程度上这一影响可通过口服类固醇激素加以预防。使甲状腺功能恢复正 常并戒烟仍然是最经济有效的干预措施。新型药物如利妥昔单克隆抗体、过氧化物酶体增殖物活化 受体一．y拮抗剂、胰岛素样生长因子一l受体阻滞剂及硒等治疗Graves眼病所取得的进展值得期待。 【关键词】Graves眼病；抗甲状腺药物；放射性碘治疗；手术；利妥昔单克隆抗体；硒 in Endocri— TherapeuticprogressGraves’ophthalmopathyCU／Huan—huan，WANGJian．Departmentof ClinicalInstitute Medical General nology，Nanjing ofSouthernUn泌rsity，NanjingHospitalofNanfingMilitary 210002，China Command，PL4，Nanjing isthemost and 【Abstract】Graves’ophthalmopathyimportant frequentextrathyroida／expression《 7 Graves variablessuchas of disease．Pre—therapy function，level ethnicity，sex，age，thyroidthyroid—stimula— ting antibodiesand irff／nence to hormone—receptor smoking response average，antithyroiddrugs therapy，On and donotinfluencethenatural of course iodidecan thyroidectomy Graves’ophthalmo—pathy．Radioactive causethe of 7 or Graves is withoralster- developmentprogressionophthahuo—pathy，whichlargelypreventable oid and from is prophylaxis．Restoringeuthyroidism stillthemosteconomicandeffective abstainingsmoking interventions．Themadeinthenew suchas progress drugs rituximab，PPAR一7 antagonist，insulin—likegrowth factor一1 blockersandseleniumfor iswort