Graves眼病(Graves’ophthalmopathy, GO),也称为甲状腺眼病或甲状腺相关眼病,是Graves病(Graves disease, GD)的主要甲状腺外表现。因为存在严重不良反应的潜在风险,目前大多数可用的药物都用于治疗中度至重度Graves眼病的患者,通常不...Graves眼病(Graves’ophthalmopathy, GO),也称为甲状腺眼病或甲状腺相关眼病,是Graves病(Graves disease, GD)的主要甲状腺外表现。因为存在严重不良反应的潜在风险,目前大多数可用的药物都用于治疗中度至重度Graves眼病的患者,通常不推荐用于治疗轻度甲状腺眼病。对于轻度甲状腺眼病,治疗的选择有限,主要包括观察随访和局部治疗,本文将对轻度Graves眼病的预防及治疗作一概述。Graves’ ophthalmopathy (GO), also known as thyroid ophthalmopathy or thyroid-associated ophthalmopathy, is the main extrathyroidal manifestation of Graves’ disease (GD). Because of the potential risk of serious adverse effects, most of the currently available drugs are used to treat patients with moderate to severe Graves’ ophthalmopathy and are generally not recommended for the treatment of mild thyroid eye disease. The treatment options for mild thyroid ophthalmopathy are limited, mainly including observation, follow-up and local treatment. This article will review the prevention and treatment of mild Graves ophthalmopathy.展开更多
文摘目的:Graves眼病是一种复杂的器官特异性自身免疫性疾病,发病机制尚不明确。补体系统中的核心成分5/5a(component 5/5a,C5/C5a)可能在该疾病的病理过程中发挥重要作用。本研究旨在利用孟德尔随机化(Mendelian randomization,MR)方法探究C5/C5a与Graves眼病的因果关系,以期为Graves眼病的诊断与治疗提供新的理论依据。方法:基于全基因组关联分析(genome-wide association study,GWAS)的汇总数据,以补体C5/C5a作为暴露因素,Graves眼病作为结局因素,分析补体C5/C5a与Graves眼病的因果关系,利用共定位分析得出假设的后验概率(posterior probability of hypothesis,PPH),进一步验证补体C5与Graves眼病的遗传关联。结果:Wald比率法模型显示补体C5与Graves眼病呈显著正相关(OR=4.109,95%CI 1.990~8.486,P<0.001),逆方差加权法(inverse variance weighted,IVW)模型显示C5a与Graves眼病同样呈正相关(OR=2.901,95%CI 1.225~6.869,P=0.015),共定位分析显示补体C5与Graves眼病在给定的遗传窗口内共享同一个单核苷酸多态性(single nucleotide polymorphism,SNP)rs7036980,PPH4为0.81(>0.80为概率高)。结论:补体C5/C5a的高水平显著增加Graves眼病的发生风险,通过靶向补体C5的抑制剂可以有效降低Graves眼病的发生风险。
文摘Graves眼病(Graves’ophthalmopathy, GO),也称为甲状腺眼病或甲状腺相关眼病,是Graves病(Graves disease, GD)的主要甲状腺外表现。因为存在严重不良反应的潜在风险,目前大多数可用的药物都用于治疗中度至重度Graves眼病的患者,通常不推荐用于治疗轻度甲状腺眼病。对于轻度甲状腺眼病,治疗的选择有限,主要包括观察随访和局部治疗,本文将对轻度Graves眼病的预防及治疗作一概述。Graves’ ophthalmopathy (GO), also known as thyroid ophthalmopathy or thyroid-associated ophthalmopathy, is the main extrathyroidal manifestation of Graves’ disease (GD). Because of the potential risk of serious adverse effects, most of the currently available drugs are used to treat patients with moderate to severe Graves’ ophthalmopathy and are generally not recommended for the treatment of mild thyroid eye disease. The treatment options for mild thyroid ophthalmopathy are limited, mainly including observation, follow-up and local treatment. This article will review the prevention and treatment of mild Graves ophthalmopathy.
