Do Subtypes of Graves' Orbitopathy Exist?
Do Subtypes of Graves' Orbitopathy Exist?
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DOI：
10.1016/j.ophtha.2010.04.004
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发表时间：
2011-01-01
期刊：
影响因子：
13.7
通讯作者：
Mourits, Maarten P.
中科院分区：
文献类型：
--
作者：
Regensburg, Noortje I.;Wiersinga, Wilmar M.;Mourits, Maarten P.
目的：描述甲状腺功能正常的Graves眼眶病(GO)患者中脂肪和肌肉体积(MV)增加的发生率，以及相关的眼部和内分泌特征。设计：连续观察病例系列。参与者：95名连续的高加索GO患者，在甲状腺眼科门诊就诊。方法：对甲状腺功能正常的GO患者进行年龄特定参考值的容量测量。主要观察指标：GO的亚组和主要特征。结果：可区分四个亚组：组1，无脂肪体积(FV)或MV增加(n=24)；组2，仅FV增加(n=5)；3组仅Mv增加(n=58)，4组Fv和Mv均增加(n=8)。与无MV增高者相比，MV增高者年龄更大，促甲状腺激素结合抑制免疫球蛋白TBII更高，凸起更多，排泄功能受损更多。Fv增高者与无Fv增高者的不同之处仅在于有更多的凸度。临床活动度评分在4组间无差异。结论：在这些GO患者中，25%的患者眼眶脂肪和MVS在特定年龄的参考范围内。仅有14%的GO患者出现Fv升高，并以突起为特征。70%的患者出现肌肉肥大，并与年龄较大、TBII值较高、更多的前凸度和运动能力受损有关。
Purpose: To describe the prevalence of fat and muscle volume (MV) increase in Graves' orbitopathy (GO) patients, calculated from computed tomography scans, and the associated ophthalmic and endocrine characteristics.Design: Consecutive, observational case series.Participants: Ninety-five consecutive Caucasian GO patients attending the thyroid eye clinic.Methods: Volumetry using age-specific reference values in untreated GO patients who had been rendered euthyroid.Main Outcome Measures: Subgroups in GO and main characteristics.Results: Four subgroups could be distinguished: Group 1, no fat volume (FV) or MV increase (n = 24); group 2, only FV increase (n = 5); group 3, only MV increase (n = 58); and group 4, both FV and MV increase (n = 8). Patients with an increase of MV were older and had higher thyroid-stimulating hormone-binding inhibitory immunoglobulin TBII, more proptosis, and more impaired ductions than those without MV increase. Patients with an increase of FV differed from those without FV increase only in having more proptosis. The clinical activity score did not differ between the 4 groups.Conclusions: Of these GO patients, 25% have orbital fat and MVs within an age-specific reference range. An increase of the FV is seen in only 14% of GO patients and characterized by proptosis. Muscle enlargement occurs in 70% of patients and is associated with older age, higher TBII values, more proptosis, and impaired motility.