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| Analysis of the Efficacy and Factors Influencing Flucocorticoid Shock Therapy in Patients with Moderate to Severe Thyroid-Related Ophthalmopathy in the Active Phase |
| LIANG Jian, ZHANG Zhen, ZENG Yi |
| The Fifth People's Hospital of Zhuhai, Guangdong Zhuhai 519055, China |
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Abstract Objective: To explore possible factors affecting the effect of glucocorticoid shock therapy for active thyroid associated ophthalmopathy (TAO) in moderate to severe ophthalmopathy. Methods: In this retrospective study, 103 patients with moderate to severe TAO during active period who received standardized pulse glucocorticoid therapy who were admitted to the Department of Endocrinology of the fifth people's hospital of zhuhai from June 2018 to March 2020 were enrolled in this study. According to the changes of eyelid retraction, exophthalmos, eye movement, and clinical activity score (CAS) after treatment, the patients were assigned into two groups: 80 cases in the significant effectiveness group and 23 cases in the ineffectiveness group. The age, gender, smoking history, exophthalmos, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), neutrophil count (NEU), lymphocyte count (LYM), neutrophil-lymphocyte ratio (NLR), thyroid stimulating hormone receptor antibodies (TRAb), anti-thyroglobulin antibodies (TGAb), thyroid peroxidase antibody (TPOAb) were collected and the related factors affecting the curative effect were analyzed. Results: There were no statistical differences in age, sex and LYM between the two groups (P>0.05). Smoking history, degree of exophthalmos, CRP, NEU, NLR ESR, TRAb, TGAb, TPOAb were statistically different between the two groups (P<0.05). Logistic regression analysis also showed that smoking history, degree of exophthalmos, CRP, ESR, NEU, NLR, TRAb, TGAb, TPOAb were associated with the effectiveness (P<0.05). Conclusion: For patients with moderate to severe TAO, age, gender, LYM were not associated with prognosis, while smoking history, exophthalmia, CRP, ESR, NEU, NLR, TRAb, TGAb, TPOAb were associated with the effectiveness. Smoking cessation and active treatment of thyroid disease can help improve the curative effect.
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2023, Vol. 29 
