目的：分析曲安奈德对甲状腺相关眼病上睑退缩的治疗效果及安全性。方法选择2014年4月至2015年3月在河北省眼科医院接受治疗的以上睑退缩为主要特征的甲状腺相关眼部患者101例，共112眼，按抽签法随机分为观察组和对照组。观察组50例55眼，给予患者进行上穹窿结膜下注射曲安奈德，每次用量0.7 mL，每周注射1次，连续治疗7周；对照组51例57眼，根据患者情况给予口服泼尼松40～60 mg，连续治疗7周。在治疗前和治疗7周后，观察记录两组患者的睑裂高度、上睑退缩值、临床活动性评分（CAS）积分的变化，并分析其疗效，统计其不良反应的症状。结果治疗7周后，观察组的总有效率为92.7％（51／55），高于对照组的71.9％（41／57），差异有统计学意义（P＜0.05）。治疗后，观察组睑裂高度和上睑退缩值低于对照组[（8.4±1.1） mm 比（9.1±1.1） mm，（0.53±0.06） mm比（0.72±0.04） mm]，差异有统计学意义（P＜0.01）。治疗后，观察组CAS积分低于对照组[（1.62±0.22）分比（3.02±0.26）分]，差异有统计学意义（P＜0.01）。结论曲安奈德治疗甲状腺相关眼病上睑退缩的患者，能有效且快速的降低患者的睑裂高度、上睑退缩值以及CAS积分，其疗效显著且稳定，安全性高，值得在临床上推广。%Objective To analyze efficacy and safety of triamcinolone acetonide for the treatment of thy-roid related ophthalmopathy,upper eyelid retraction.Methods Total of 101 patients(112 eyes) with thyroid related upper eyelid retraction in Hebei Province Ophthalmology Hospital from Apr .2014 to Mar.2015 were included in the study,and were randomly divided into observation group and control group according to the drawing method.The observation group of 50 cases(55 eyes) ,was given the vault subconjunctival injection of triamcinolone acetonide,0.7 mL per time,once a week,continuously for seven weeks;the control group of 51 cases(57 eyes),was given oral prednisone 40-60 mg according to patients condition,for 7 weeks continuously. Before treatment and after 7 weeks of treatment,the palpebral fissure height,upper eyelid retraction value,the change of the clinical activity scoreCAS) integral of the two groups were observed,and the curative effect,the symptoms of adverse reactions were analyzed and statistically recorded .Results Seven weeks after treat-ment,the total effective rate of the observation group was higher than the control group [ 92.7%(51/55) vs 71.9%(41/57)],the difference was statistically significant(P <0.05).After treatment,palpebral fissure height and upper eyelid retraction value of the observation group were lower than the control group [ ( 8.4 ± 1.1) mm vs (9.1 ±1.1) mm,(0.53 ±0.06) mm vs (0.72 ±0.04) mm],the differences were statistically significant(P<0.01).After treatment,CAS scores of the observation group was lower than the control group [ (1.62 ±0.22) scores vs (3.02 ±0.26) scores],the difference was statistically significant(P<0.01). Conclusion Triamcinolone acetonide treating patients with thyroid related ophthalmopathy upper eyelid re-traction,can effectively and quickly reduce the palpebral fissure of height,upper eyelid retraction value and CAS integrals,which can be described as significant and stable efficacy,high safety,thus is worth populari-zing in clinical.
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