[1]檀 香,马友凤,黄丽芬,等.托珠单抗联合糖皮质激素治疗中重度活动期甲状腺相关眼病临床价值研究[J].陕西医学杂志,2026,(5):664-668.[doi:DOI:10.3969/j.issn.1000-7377.2026.05.016]
　TAN Xiang,MA Youfeng,HUANG Lifen,et al.Clinical value of tocilizumab combined with glucocorticoids in the treatment of moderate to severe active thyroid-associated ophthalmopathy[J].,2026,(5):664-668.[doi:DOI:10.3969/j.issn.1000-7377.2026.05.016]
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托珠单抗联合糖皮质激素治疗中重度活动期甲状腺相关眼病临床价值研究

《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

卷:
期数:
2026年5期
页码:
664-668
栏目:
药物与临床
出版日期:
2026-05-05

文章信息/Info

Title:
Clinical value of tocilizumab combined with glucocorticoids in the treatment of moderate to severe active thyroid-associated ophthalmopathy
作者:
檀 香; 马友凤; 黄丽芬; 廖安迪; 周 梅
（中国人民解放军联勤保障部队第九二三医院，广西 南宁 530021）
Author(s):
TAN Xiang; MA Youfeng; HUANG Lifen; LIAO Andi; ZHOU Mei
(923 Hospital of the PLA Joint Logistics Support Force,Nanning 530021,China)
关键词:
甲状腺相关眼病; 活动期; 托珠单抗; 糖皮质激素; 复视; 安全性
Keywords:
Thyroid-associated ophthalmopathy; Active phase; Tocilizumab; Glucocorticoids; Diplopia; Safety
分类号:
R77
DOI:
DOI:10.3969/j.issn.1000-7377.2026.05.016
文献标志码:
A
摘要:
目的：探讨托珠单抗联合糖皮质激素治疗中重度活动期甲状腺相关眼病（TAO）的临床价值。方法：选取106例中重度活动期TAO患者，随机分为对照组（静脉糖皮质激素冲击治疗）和观察组（托珠单抗联合糖皮质激素冲击治疗），各53例。记录两组临床疗效，比较两组治疗前后甲状腺功能指标、眼部指标及复视情况，记录不良反应发生情况。结果：观察组总有效率高于对照组，总不良反应发生率低于对照组（均P＜0.05）。治疗后，两组血清游离三碘甲状腺原氨酸（FT3）、游离甲状腺素（FT4）水平与同组治疗前比较差异无统计学意义（均P＞0.05）；两组血清促甲状腺激素（TSH）水平较同组治疗前升高（均P＜0.05），但组间比较差异无统计学意义（P＞0.05）；两组血清促甲状腺激素受体抗体（TRAb）水平、眼外肌最大横截面积（EMA）、平均T2弛豫时间（T2RTmean）、眼球突出度及复视评分较同组治疗前降低，且观察组低于对照组（均P＜0.05）。结论：托珠单抗联合糖皮质激素治疗中重度活动期TAO患者效果较好，可改善眼球突出度和复视情况，降低不良反应发生率，安全性更高。
Abstract:
Objective:To explore the clinical value of tocilizumab combined with glucocorticoids in the treatment of moderate to severe active thyroid-associated ophthalmopathy (TAO).Methods：A total of 106 patients with moderate to severe active TAO were enrolled and randomly divided into a control group (intravenous glucocorticoid pulse therapy) and an observation group (tocilizumab combined with intravenous glucocorticoid pulse therapy),with 53 cases in each group.The clinical efficacy of the two groups was recorded.Thyroid function indicators,ocular indicators and diplopia status before and after treatment were compared between the two groups,and the occurrence of adverse reactions was recorded.Results:The total effective rate of the observation group was higher than that of the control group,and the total incidence of adverse reactions was lower than that of the control group (all P<0.05).After treatment,there were no significant differences in the serum levels of free triiodothyronine (FT3) and free thyroxine (FT4) between the two groups compared with those before treatment in the same group (all P>0.05).The serum thyroid-stimulating hormone (TSH) level in both groups was higher than that before treatment in the same group (all P<0.05),but there was no significant difference between the two groups (P>0.05).The serum thyroid-stimulating hormone receptor antibody (TRAb) level,maximum cross-sectional area of extraocular muscles (EMA),mean T2 relaxation time (T2RTmean),exophthalmos and diplopia score in both groups were lower than those before treatment in the same group,and the observation group was lower than the control group (all P<0.05).Conclusion:Tocilizumab combined with glucocorticoids has a good effect in the treatment of patients with moderate to severe active TAO,which can improve exophthalmos and diplopia,reduce the incidence of adverse reactions,and has higher safety.

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备注/Memo

备注/Memo:
广西壮族自治区重点研发计划项目（2023RX-1096）
更新日期/Last Update: 2026-05-05