摘要目的 观察甲状腺相关性眼病(TAO)眼外肌厚度的变化与眼球突出度的关系,为指导临床治疗提供科学依据.方法 选择2005年5月至2011年5月在解放军第451医院确诊为TAO的患者作为观察对象,将其分为TAO组和治疗组,分别为23、24例.同时以健康体检者32例作为对照组.采用B超检测各眼外肌厚度(包括内直肌、外直肌、上直肌、下直肌),计算双眼直肌厚度总和,Hertel突眼计检测眼球突出度.结果 对照组、TAO组、治疗组观察对象内直肌厚度分别为(3.35±0.25)、(4.38±0.85)、(3.58±0.52)mm,外直肌厚度分别为(2.95±0.61)、(4.24±0.75)、(3.65±0.42)mm,上直肌厚度分别为(3.15±0.20)、(4.65±0.68)、(4.01±0.15)mm,下直肌厚度分别为(3.17±0.72)、(4.75±0.52)、(3.71±0.91)mm,双眼直肌厚度总和分别为(21.95±0.65)、(28.02±1.51)、(22.95±0.65)mm,组间比较差异有统计学意义(F值分别为2.32、2.43、2.25、2.17、5.63,P均＜ 0.05)；其中TAO组各直肌厚度及双眼直肌厚度总和明显高于对照组和治疗组(P均＜0.05),而对照组和治疗组间比较,差异无统计学意义(P均＞ 0.05).TAO组、治疗组观察对象眼球突出度分别为(16.82±2.46)、(14.52±1.83)mm,且两组双眼直肌厚度总和与眼球突出度均呈正相关(r值分别为0.65、0.58,P均＜0.05).结论 TAO的眼外肌厚度与眼球突出度呈正相关关系,B超检测其变化对临床诊治有实际的指导意义.

abstractsObjective To study the relationship between extraocular muscle thickness and exophthalmos degree in patients with thyroid-associated ophthalmopathy (TAO),so as to provide a scientific basis for guiding clinical treatment.Methods Forty seven patients diagnosed with TAO from May 2005 to May 2011,in the 451 Hospital of the People's Liberation Army were chosen in this study,and divided into TAO group(23 cases) and treatment group (24 cases).Meanwhile,another 32 healthy people were selected as control.Extraocular rectus muscles (including the medial rectus muscle,lateral rectus muscle,superior rectus muscle and inferior rectus muscle) of all participants were measured with B-scan ultrasonography,and exophthalmos degree with Hertel exophthalmometer.Results The thicknesses of medial rectus in control group,TAO group and treatment group were (3.35 ± 0.25),(4.38 ± 0.85),(3.58± 0.52)mm,respectively; the thicknesses of lateral rectus muscle were (2.95 ± 0.61),(4.24 ± 0.75),(3.65 ± 0.42)mm,respectively; the thicknesses of superior rectus muscle were (3.15 ± 0.20),(4.65± 0.68),(4.01 ± 0.15)mm,respectively; the thicknesses of inferior rectus muscle were (3.17 ± 0.72),(4.75 ± 0.52),(3.71 ± 0.91)mm,respectively; the sums of binocular rectus thickness in these three groups were (21.95 ± 0.65),(28.02 ± 1.51),(22.95 ± 0.65)mm,respectively; the difference between the three groups was statistically significant(F=2.32,2.43,2.25,2.17,5.63,all P ＜ 0.05),and TAO group was significantly higher than that in the control group and in the treatment group(all P ＜ 0.05),while there was no statistically significant between the control group and the treatment group(all P ＞ 0.05).The eyes exophthalmos degree in TAO group and treatment group were (16.82 ± 2.46),(14.52 ± 1.83)mm,respectively.The sum of the rectus muscle thickness and eyes exophthalmos was positively correlated(r =0.65,0.58,all P ＜ 0.05).Conclusions Extraocular muscle thickness in patients with TAO is positively correlated with exophthalmos degree,and using B-scan ultrasonography to detect the changes is practical for clinical diagnosis and treatment.