Observation on the clinical therapeutic effect of intensity modulated radiation therapy for Graves'ophthalmopathy exophthalmos
Objective To investigate the effect of intensity modulated radiotherapy(IMRT)on the treatment of patients with Graves ophthalmopathy(GO)exophthalmos and analyze the influence on the changes of thyrotropin receptor antibody(TRAb),CD3,CD3+CD4+,CD3+CD8+,CD4+/CD8+ratio before and after the radiotherapy.Methods A total of 23 patients with GO exophthalmos were admitted to Anyang District Hospital of Puyang City from January 2021 to January 2023,and were selected as the study objects.Treatment for the pathological tissue behind the eyeball frame was carried out by using IMRT with 2 Gy/time,5 times/week,10 times in total,and a total dose of 20 Gy.The exophthalmos degrees of patients with GO were measured,and the symptoms of GO were evaluated,which were compared before radiotherapy,the 10th time of radiotherapy,and 3 months after radiotherapy respectively.The contents of TRAb,CD3,CD3+CD4+,CD3+CD8+,and ratio of CD4+/CD8+were measured as well,which were compared before radiotherapy,the 10th time of radiotherapy,and 3 months after radiotherapy respectively.Results The exophthalmos degree of patients with GO in the 10th time of radiotherapy and 3 months after radiotherapy were significantly lower than that of before radiotherapy(P＜0.05),and the exophthalmos degree in 3 months after radiotherapy was significantly lower than that of the 10th time of radiotherapy(P＜0.05);Significant improvement rate of symptoms of GO(eyelid swelling,photophobia and tears,eyelid unclosed,eye pain,eye movement disorder,vision loss,diplopia)in the 10th time of radiotherapy and 3 months af-ter radiotherapy were significantly higher than that of before radiotherapy(P＜0.05),and the significant improvement rate of symptoms in 3 months after radiotherapy was higher than that of the 10th time of radiotherapy(P＜0.05);the contents of TRAb,CD3+CD4+,and CD4+/CD8+rate before radiotherapy were significantly higher than those after the 10th time of radiotherapy and 3 months after radiotherapy(P＜0.05),the contents of TRAb,CD3+CD4+,and CD4+/CD8+rate in the 10th time of radiotherapy were higher than those in 3 months after radiotherapy as well(P＜0.05);the counts of CD3+CD8+in GO patients before radiotherapy were significantly lower than that of the 10th time of radiotherapy and 3 months after radiotherapy(P＜0.05),and the counts of CD3+CD8+in the 10th time of radiotherapy was significantly low-er than that of 3 months after radiotherapy(P＜0.05).Conclusion IMRT has significant effect on the exophthalmos de-gree and the symptoms of GO patients.It provides a better option for treating patients with GO.Addtionally,the contents of TRAb,CD3+CD4+,CD3+CD8+and the ratio of CD4+/CD8+can be used as indicators for disease assessment and ef-ficacy evaluation of patients with GO exophthalmos before and after radiotherapy.
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