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相關文獻
- 甲狀腺眼病變的致病機轉和處置
- 葛瑞夫茲氏眼病變--Graves' Ophthalmopathy
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- 葛瑞夫茲氏眼病變--從致病機轉到處理
- Graves’ Disease葛瑞夫茲氏病
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- Thymic Hyperplasia in a Patient with Graves' Disease
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頁籤選單縮合
題名 | 葛瑞夫茲氏眼病變--Graves' Ophthalmopathy=Graves' Ophthalmopathy |
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作者 | 鍾岳樺; 游新; 吳達仁; | 書刊名 | 內科學誌 |
卷期 | 13:2 2002.04[民91.04] |
頁次 | 頁79-85 |
分類號 | 415.931 |
關鍵詞 | 葛瑞夫茲氏病; 葛瑞夫茲氏眼病變; Graves' disease; Graves' ophthalmopathy; |
語文 | 中文(Chinese) |
中文摘要 | 除了甲狀腺亢進以外 , 眼睛病變是葛瑞夫茲氏病 (Graves' disease ) 最常見到的 臨床病症 , 而且會造成病人視力及容貌損傷。葛瑞夫茲氏眼病變 (Graves' ophthalmopathy) 的種種臨床表現主要是因為 glycosaminoglycans(GAG ) 的大 量製造及堆積於眼球所造成。這個過程主要是因為 T 淋巴球經由附著分子 (adhesion molecules ) 浸潤到眼球並釋放出許多 cytokines , 進而刺激纖維母細胞 增生及大量合成 GAG 。 T 淋巴球所辨識的抗原應該是甲狀腺和眼球所共有 , 而目前的研究發現這個抗原可能就是 TSH 受器 (TSH-receptor) 。葛瑞夫茲氏眼病變 的治療主要決定於疾病的嚴重度 (severity) 及活動度 (activity) 。較嚴重的葛瑞夫茲氏眼病變才需要積極地治療; 如果眼病變不嚴重 , 支持性療法通常就已足 夠。目前葛瑞夫茲氏眼病變的治療方式主要有高劑量類固醇 , 放射治療以及眼球 減壓手術。如果眼病變是處於活動期 , 以上的治療方式都可使用 ; 如果眼病變 是處於不活動期 , 則藥物及放射治療的效果不好 , 而以手術治療為主。目前有一 些新發展的治療方法如 somatostatin analogs, 靜脈注射免疫球蛋白 (IVIG), cyc1ospori, 和 anticytokine therapy, 但其療效仍有待進一步的評估。 |
英文摘要 | Graves' opthalmopathy is the most frequent extrathyroidal manifestation and it is potentially disfiguring and sight-threatening. The clinical manifestations of Graves' ophthalmopathy result largely from overproduction of glycosaminoglycans (GAG) within the orbit. This process is likely to be driven by T cells that access and infiltrate the orbital space via certain adhesion molecules, and release various cytokines capable of stimulating cell proliferation, GAG synthesis and the expression of immunomodulatory molecules in retroocular fibroblasts. The TSH-receptor (TSH-R) is probably a shared antigen by the thyroid and the orbit. Management of Graves' ophthalmopathy depends on its severity and activity. In severe form of the disease, aggressive measures are required. If the disease is active, high-dose glucocorticoids , orbital radiotherapy, or orbital decompression represent the mainstay of treatment. Established treatments are glucocorticoids, orbital radiotherapy, orbital decompression. Novel treatments such as somatostatin analogs or IVIG are under evaluation. (J Intern Med Taiwan 2002; 13:79 -85 ) |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。