实用临床医药杂志2025，Vol.29Issue(4)：11-15,22,6.DOI:10.7619/jcmp.20244709
利妥昔单抗眼眶注射联合甲泼尼龙静脉滴注对Graves眼病的疗效及免疫系统的影响
Efficacy of rituximab orbital injection combined with intravenous drip of methylprednisolone in treating Graves'ophthalmopathy and its influence on immune system
摘要
Abstract
Objective To explore the efficacy of rituximab(RTX)orbital injection combined with intravenous drip of methylprednisolone in treating Graves'ophthalmopathy.Methods A total of 102 patients with Graves'ophthalmopathy in the Ziyang City People's Hospital from July 2021 to Janu-ary 2023 were randomly divided into combination group(n=34),methylprednisolone group(n=34),and RTX group(n=34).The methylprednisolone group was given glucocorticoids(methylpred-nisolone)monotherapy,the RTX group was given RTX monotherapy,and the combination group was given RTX combined with methylprednisolone.The total effective rate,ophthalmic manifestations,thy-roid volume,thyroid immune antibodies[thyroid globulin antibody(TGAb),thyrotropin receptor anti-body(TRAb)and thyroid peroxidase antibody(TPOAb)levels],the Clinical Activity Scale(CAS),levels of immunoglobulins in peripheral blood[immunoglobulin G4(IgG4)and IgG4/IgG],and ad-verse reactions were compared among the three groups.Results The total effective rate was 97.06％(33/34)in the combination group,which was significantly higher than 79.41％(27/34)in the meth-ylprednisolone group and 76.47％(26/34)in the RTX group(P＜0.05).After 4 and 8 weeks of treat-ment,the exophthalmos degree,interocular distance,intraocular pressure,and retrobulbar soft tissue volume in the combination group were significantly lower than those in the methylprednisolone group and the RTX group(P＜0.05);the thyroid volume and the CAS score in the combination group were significantly lower than those in the methylprednisolone group and the RTX group(P＜0.05);the TGAb,TRAb and TPOAb levels in the combination group were significantly lower than those in the methylprednisolone group and the RTX group(P＜0.05);the IgG4 and IgG4/IgG in the com-bination group were significantly lower than those in the methylprednisolone group and the RTX group(P＜0.05).There was no significant difference in the incidence of adverse reactions among the three groups(P＞0.05).Conclusion For patients with Graves'ophthalmopathy,therapeutic effect of RTX orbital injection combined with intravenous drip of methylprednisolone is better,which is beneficial for improving ophthalmic manifestations and regulating levels of TGAb,TRAb,TPOAb and immunoglobulins.关键词
Graves眼病/利妥昔单抗/糖皮质激素/抗甲状腺球蛋白抗体/抗促甲状腺素受体抗体/抗甲状腺过氧化物酶抗体Key words
Graves'ophthalmopathy/rituximab/glucocorticoids/thyroid globulin antibody/thyrotropin receptor antibody/thyroid peroxidase antibody分类
医药卫生引用本文复制引用
张发蓉..利妥昔单抗眼眶注射联合甲泼尼龙静脉滴注对Graves眼病的疗效及免疫系统的影响[J].实用临床医药杂志,2025,29(4):11-15,22,6.基金项目
2021年四川省科研课题计划(S21216) （S21216）
