摘要
目的探讨商业化软件计算球后脂肪体积,分析其与甲状腺相关性眼病(TAO)进展及预后的关系。方法收集2016年1月~2016年12月在我院内分泌科确诊的35例(70个眼眶)TAO患者的临床资料。测量1.5T眼眶MRI球后脂肪体积及眼外肌信号强度比值(SIR)分析其与临床各项指标的相关性,并收集12例(24个眼眶)健康人测量球后脂肪体积,初步比较TAO组及健康组体积的差异。结果脂肪体积与病程成正相关(r=0.480,P<0.01),病程6个月以内组与6~12个月组相比,脂肪体积差异不显著(P=0.084)。病程6个月以内组及病程6~12个月组球后脂肪体积均显著低于病程大于12个月组(P<0.01,P<0.05)。脂肪体积与突眼度存在相关性(r=0.622,P<0.01),突眼度每增加1 mm,球后脂肪体积将增加0.88 m L。临床活动性评分(CAS)与SIR值及促甲状腺素受体抗体(TRAb)存在相关性(r=0.536,r=0.416,P<0.01)。TAO组球后脂肪体积显著高于正常组(P<0.01)。结论 TAO病程1年以上可能是球后脂肪组织增多的高峰阶段,球后脂肪体积结合SIR值的测量有助于最佳激素治疗时机的探索及预后分析。
Objective To analyze the relationship between orbital fat volume and the progression and prognosis of thyroidassociated ophthalmopathy(TAO) and determine the optimal treatment timing for TAO. Methods The clinical data were collected from 35 patients(70 orbits) with a definite diagnosis of TAO between January, 2016 and December, 2016. The correlation between orbital fat volume and the clinical parameters was evaluated. We also analyzed the correlation of the signal intensity ratio(SIR) of the extraocular muscles with the clinical parameters. The orbital fat volume was compared between patients with TAO and 12 control subjects. Results The orbital fat volume was significantly correlated with the duration of TAO(r=0.480, P<0.01), but showed no significant difference between patients with a disease course within 6months and those with a disease course of 6 to 12 months(P=0.084). The patients with a disease course beyond 12 months had a significantly greater orbital fat volume than those with a disease course of 6 months(P<0.01) or 6 to 12 months(P<0.05). The orbital fat volume was correlated with the degree of proptosis(r=0.622, P<0.01), and an increase of exophthalmos by 1 mm was associated with a total orbital volume increment of 0.88 m L. The clinical activity score was correlated with the SIR of the extraorbital muscles(r=0.536, P<0.01) and levels of anti-thyroid-stimulating hormone receptor antibody(r=0.416,P<0.01). The orbital fat volume was significantly greater in TAO patients than in the healthy individuals(P<0.01). Conclusion In patients with TAO, the peak increase of orbital fat volume occurs one year after the disease onset. Measurement of the orbital fat volume combined with SIR of the extraorbital muscles can serve as an indicator for determining the optimal timing for intervention of TAO and helps in the evaluation of prognosis of the patients.
出处
《南方医科大学学报》
CAS
CSCD
北大核心
2017年第5期640-645,共6页
Journal of Southern Medical University
基金
南方医科大学"临床科研启动计划"(LC2016PY046)
