中国甲状腺眼病治疗临床实践调查

IF 3.5 2区 医学 Q2 ENDOCRINOLOGY & METABOLISM European Thyroid Journal Pub Date : 2024-04-01 DOI:10.1530/etj-23-0269
Chen Jingyue, Chenyan Li, Weiping Teng, Zhongyan Shan, Jun Jin, Yining Wei, Jing Sun, Yushu Li, Huifang Zhou
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引用次数: 0

摘要

目的:几十年来,甲状腺眼病(TED)的治疗发生了重大变化。本研究旨在调查中国目前治疗甲状腺眼病的临床实践:方法:于2023年4月至5月进行了在线问卷调查。问卷内容包括TED的诊断标准、多学科治疗(MDT)协作以及轻度、中度和重度TED的治疗偏好:共收集到 289 份问卷,其中 165 份来自内分泌科医生,124 份来自眼科医生。只有 36.68% 的参与者声称他们所在的机构有 TED MDT 临床模式。生物制剂的覆盖率约为10%或更低。这明显低于西方国家。62.63%的参与者认为近年来TED的发病率有所上升。成像技术被广泛用于协助诊断 TED。然而,中国人对突眼的定义仍存在争议。大多数医生会控制危险因素,并提供人工泪液和眼镜等眼眶支持治疗。对于轻度活动性TED,内分泌科医生(39.39%)倾向于建议单纯治疗甲状腺功能亢进,而眼科医生(43.55%)则倾向于眶内注射皮质类固醇。目前,中度至重度活动性 TED 最广泛采用的治疗方法是大剂量静脉注射皮质类固醇(94.81%),而眼眶放疗联合免疫抑制剂是最被认可的二线疗法(43.60%)。结论该研究记录了中国目前治疗 TED 的临床实践与最近更新的指南之间的一致性和差异。眼科和内分泌科之间存在明显差异,需要优化管理。
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A Chinese Survey of Clinical Practice on the Management of Thyroid Eye Disease

objective:The management of thyroid eye disease (TED) has undergone significant changes for decades. The study sought to investigate current clinical practice on the management of TED in China.

Methods: An online questionnaire survey was conducted from April to May 2023. The questionnaire involved diagnostic criteria for TED, multidisciplinary treatment (MDT) collaboration, and treatment preference for mild, moderate, and severe TED.

Results: A total of 289 questionnaires were collected, with 165 from endocrinologists and 124 from ophthalmologists. Only 36.68% participants claimed there was MDT clinical pattern for TED in their institutions. The coverage of biologic agents was around 10% or lower. These were distinctly lower than western countries. 62.63% participants believed the incidence of TED has increased in recent years. Imaging techniques were used widely to assist in the diagnosis of TED. However, there was still controversy regarding the definition of proptosis in Chinese population. Most doctors managed risk factors and provided orbital supportive treatments of artificial tears and glasses. For mild active TED, endocrinologists (39.39%) inclined to recommend therapy for hyperthyroidism alone and ophthalmologists (43.55%) preferred orbital corticosteroid injections. Currently, the most widely used treatment for moderate to severe active TED was high-dose intravenous corticosteroid (94.81%), while orbital radiotherapy combined with immunosuppressive agents was the most recognized second-line therapy (43.60%).

Conclusion: The study documented the consistency and differences between current clinical practices on the management of TED in China and the recently updated guidelines. There was a remarkable difference between ophthalmology and endocrinology departments, warranting management optimization.

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来源期刊
European Thyroid Journal
European Thyroid Journal Medicine-Endocrinology, Diabetes and Metabolism
CiteScore
6.70
自引率
2.10%
发文量
156
期刊介绍: The ''European Thyroid Journal'' publishes papers reporting original research in basic, translational and clinical thyroidology. Original contributions cover all aspects of the field, from molecular and cellular biology to immunology and biochemistry, from physiology to pathology, and from pediatric to adult thyroid diseases with a special focus on thyroid cancer. Readers also benefit from reviews by noted experts, which highlight especially active areas of current research. The journal will further publish formal guidelines in the field, produced and endorsed by the European Thyroid Association.
期刊最新文献
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