Effect of octreotide treatment on Graves' ophthalmopathy.
Effect of octreotide treatment on Graves' ophthalmopathy.
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奥曲肽治疗格雷夫斯眼病的效果。
DOI：
10.1507/endocrj.46.573
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发表时间：
1999
影响因子：
2
通讯作者：
G. Erdogan
中科院分区：
文献类型：
--
作者：
A. Uysal;D. Çorapçıoğlu;V. Tonyukuk;S. Güllü;H. Sav;N. Kamel;G. Erdogan
在这项研究中，9 名临床活动评分 (CAS) 呈阳性、无反应或不适合糖皮质激素治疗的格雷夫斯眼病患者每天皮下注射 3 次，每次 100 微克奥曲肽，持续三个月。平均年龄为 49+/-13 岁。所有患者均接受丙硫氧嘧啶或甲硫咪唑治疗，并且在开始奥曲肽治疗前至少一个月甲状腺功能正常。治疗后，用 Hertel 眼球突出度计测量的平均突眼程度略有下降（右眼为 22.0+/-3.0 vs 19.6+/-2.4，左眼为 22.2+/-1.9 vs 20.2+/-2.2；p<0.05）。平均活动评分从 3.2+/-0.8 下降至 1.7+/-1.1 (p<0.005)，并且根据 NOSPECS 分类的眼部体征平均评分显示奥曲肽治疗有所改善（3.2+/-0.7 与 2.2+/-1.4；p<0.05）。七名患者对奥曲肽治疗反应良好。其余两个没有观察到任何改善。其中 4 名有反应者在治疗后可进行 20 个月的随访，并且所有人都保持了奥曲肽获得的良好眼部检查结果。我们的结论是，奥曲肽似乎是治疗格雷夫斯眼病的一种安全有效的药物，特别是在改善软组织受累方面，并且可用于对糖皮质激素治疗无反应或因某种原因不能使用这些药物的患者。
In this study, nine patients with Graves' ophthalmopathy with positive clinical activity score (CAS), who were either unresponsive or not suitable for glucocorticoid treatment, were given 100 microg of octreotide three times daily, subcutaneously, for three months. The mean age was 49+/-13 years. All patients were under either propylthiouracil or methimazole therapy and were euthyroid for at least one month prior to the start of the octreotide treatment. The mean degree of proptosis as measured with the Hertel exophthalmometer decreased slightly after the treatment (22.0+/-3.0 vs 19.6+/-2.4 for the right eye and 22.2+/-1.9 vs 20.2+/-2.2 for the left eye; p<0.05). The mean activity score decreased from 3.2+/-0.8 to 1.7+/-1.1 (p<0.005) and the mean score of eye signs according to the NOSPECS classification showed improvement with octreotide therapy (3.2+/-0.7 vs. 2.2+/-1.4; p<0.05). Seven patients responded favorably to octreotide treatment. In the remaining two no improvement was observed. Four of the responders could be followed up for 20 months after the treatment and all maintained the favorable state of eye findings obtained with octreotide. We conclude that octreotide seems to be a safe and effective drug in Graves' ophthalmopathy, especially in improving soft tissue involvement, and can be used in patients who are unresponsive to glucocorticoid treatment or who cannot use these drugs for some reason.