Objective To evaluate the efficacy of treatment of thyroid-associated ophthalmopathy with retrobular injection of glucocorticoid. Methods We searched The Cochrane Library (Issue 1, 2010), EBM Reviews, PubMed and CBMdisc to collect randomized controlled trials (RCTs) of retrobular injection of glucocorticoid for thyroid-associated ophthalmopathy. The quality of the included trials was assessed and meta-analyses were conducted by RevMan 4.2.8 software. We conducted subgroup analyses based on the outcome measures and intervention. Results A total of 7 RCTs were identified. There were significant differences between retrobular injection of glucocorticoid and blank in the effective rate (RR= 1.35, 95%CI 1.10 to 1.65, P=0.004). There were no significant differences between retrobular injection of glucocorticoid and oral glucocorticoid in the effective rate (RR= 1.15, 95%CI 0.93 to 1.42, P=0.20). And there were significant differences between retrobular injection of glucocorticoid alone and retrobular injection of glucocorticoid combined with radiotheraphy in the effective rate (RR= 0.85, 95%CI 0.72 to 1.00, P=0.04). Three patients of the ROGC experienced intraorbital hemorrhage and two of the ROGC experienced aggravation of soft tissues. There were no systemic adverse reactions such as weight gaining and Cushing’s syndrome. Conclusion Retrobular injection of glucocorticoid appears to be an effective treatment for thyroid-associated ophthalmopathy. And combination retrobular injection of glucocorticoid with radiotheraphy seems to be more effective.
目的:探讨重组人IGF-1和生长抑素-14单独及联合应用对甲状腺相关眼病患者眼眶成纤维细胞增殖的影响。方法:体外培养甲状腺相关眼病患者眼眶成纤维细胞,采用四甲基偶氮唑盐(MTT)比色法检测不同浓度及作用时间的重组人IGF-1和生长抑素-14对细胞增殖的作用。结果:50μg/L以上浓度IGF-1对眼眶成纤维细胞有促增殖作用,5nmol/L以上浓度的SST对眼眶成纤维细胞的生长有抑制作用,均呈量效和时效关系。IGF-1和SST联合应用时, 50nmol/L以上的SST能阻断100μg/L的IGF-1促细胞增殖的作用。结论:IGF-1可刺激眼眶成纤维细胞增殖。SST能抑制眼眶成纤维细胞增殖,并能阻断IGF-1促进细胞增殖的作用,此抑制作用与浓度有关,提示SST能直接通过受体后机制抑制IGF-1诱导的眼眶成纤维细胞增殖。
ObjectiveTo compare the radiation dose distribution in irradiated target area and organs at risk among conventional radiotherapy, conformal radiotherapy and semi-field conformal radiotherapy in Graves' ophthalmopathy patients. MethodsThirty patients with Grave's ophthalmopathy treated between January 2010 and December 2012 were included in this study.CT scan was performed to obtain images of each patients; three-dimensional planning system (3D-TPS) was done to design conventional radiotherapy, conformal radiotherapy and semi-field conformal radiotherapy for each patient.Then, we counted the standard deviation of study parameters for each radiotherapy technique, and the results were compared among the three groups. ResultsAverage irradiation dose in target area of patients accepting conventional irradiation, conformal irradiation and semi-field conformal irradiation therapy was not significantly different (P > 0.05).V95 and the conformity index values of conformal irradiation and semi-field conformal irradiation therapy were better than those of the conventional irradiation therapy (P < 0.001), while no significant difference between conformal irradiation and semi-field conformal irradiation therapy was detected (P > 0.05).Patients accepting conventional irradiation got the highest cumulative irradiation dose in eye lens, while patients accepting semi-field conformal irradiation therapy got the lowest irradiation dose in eye lens, and the differences were significant (P < 0.05).Patients accepting conventional irradiation got the highest cumulative irradiation dose in pituitary, while cumulative irradiation dose in pituitary in patients accepting conformal irradiation and semi-field conformal irradiation therapy was not significantly different (P > 0.05). ConclusionsConformal irradiation and semi-field conformal irradiation techniques are superior to conventional irradiation technique, with a better target conformal degree and higher does distribution in target area, as well as a lower radiation dose in normal tissues surrounding target area.Semi-field conformal irradiation technique has a better performance than conformal irradiation therapy in eye lens protection.