Study the influencing factors on the therapeutic effect of glucocorticoid impact in the treatment of active thyroid-related eye diseases
10.3760/cma.j.cn115455-20240806-00680
- VernacularTitle:糖皮质激素冲击治疗活动期甲状腺相关眼病疗效的影响因素研究
- Author:
Xiangying ZHU
1
;
Li DING
1
;
Bin YE
1
;
Xiaozhen JI
1
Author Information
1. 丽水市人民医院内分泌科,丽水 323000
- Publication Type:Journal Article
- Keywords:
Graves ophthalmopathy;
Glucocorticoids;
Treatment outcome;
Risk factors
- From:
Chinese Journal of Postgraduates of Medicine
2025;48(10):890-894
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the influencing factors on the therapeutic effect of glucocorticoid impact in the treatment of active thyroid-related eye diseases.Methods:A total of 106 patients with thyroid-related eye disease admitted to Lishui People's Hospital from December 2020 to January 2024 were retrospectively selected, all of whom were treated with glucocorticoid impact therapy. According to the efficacy, they were divided into poor efficacy group (34 cases) and good efficacy group (72 cases), and relevant clinical data of the two groups were compared. Single factor and multiple factor Logistic regression were used to analyze the risk factors affecting the curative effect.Results:The proportion of smoking history in the poor efficacy group was higher than that in the good efficacy group:73.53% (25/34) vs. 29.17% (21/72), there was statistical difference ( χ2 = 18.50, P<0.01). The thyroid stimulating hormone (TSH) and lymphocyte (LYM) in the poor efficacy group were lower than those in the good efficacy group: (0.08 ± 0.02) mU/L vs. (0.10 ± 0.02) mU/L, 0.175 ± 0.028 vs. 0.192 ± 0.031;the free triiodothyronine (FT 3), free thyroxine (FT 4), tumor necrosis factor - α (TNF- α), interleukin (IL) -6, IL-8, neutrophil-to-lymphocyte ratio (NLR), degree of proptosis, and clinical activity score (CAS) were higher than those in the good efficacy group: (5.28 ± 1.21) pmol/L vs. (4.73 ± 1.03) pmol/L, (15.52 ± 2.35) pmol/L vs. (14.28 ± 2.31) pmol/L, (11.82 ± 2.11) ng/L vs. (10.05 ± 2.04) ng/L, (2.12 ± 0.21) ng/L vs. (1.96 ± 0.18) ng/L, (38.56 ± 4.35) ng/L vs. (35.46 ± 4.21) ng/L, 2.52 ± 0.41 vs. 1.67 ± 0.37, (17.42 ± 2.44) mm vs. (15.32 ± 2.27) mm, (4.34 ± 0.65) scores vs. (3.98 ± 0.63) scores, there were statistical differences ( P<0.05). Multiple Logistic regression analysis showed that smoking history, TSH, FT 3, FT 4, TNF-ɑ, IL-6, IL-8, LYM, NLR, exophthalmia and CAS score were all included in the regression equation, and they were all influential factors affecting the efficacy of glucocorticoid shock therapy for thyroid-related eye diseases ( P<0.05). Conclusions:In active thyroid-related eye disease patients receiving glucocorticoid impact therapy, the efficacy may be affected by many factors, and comprehensive intervention should be implemented according to the actual situation to further improve the efficacy.