背景:硒是一种对甲状腺功能至关重要的微量元素,并对Graves眼眶病(GO)具有潜在的治疗益处。因此,我们的目标是评估其在GO患者中的疗效和安全性,以提供有关其作为该疾病治疗选择的有价值的见解.
方法:系统评价和荟萃分析。
方法:与安慰剂相比,用硒治疗的GO患者。
方法:临床活动评分(CAS),Graves\'眼眶病生活质量(GO-QOL),眼部症状和体征,和不良事件。
结果:在筛选的1684条记录中,纳入4项随机对照试验.硒在6个月时在降低CAS方面优于(MD=-1.27,95%置信区间[CI][-1.68,-0.85],p<.0001]),提高总GO-QOL(RR=2.54,95%CI[1.69-3.81],p<.00001),改善视觉和心理功能评分(MD=10.84,95%CI[4.94-16.73],p=.003),(MD=12.76,95%CI[8.51-17.00],p<.00001)。同样,它在12个月时显著改善了这些结局.它还显示6个月时的睑孔明显减小(MD=-1.49,95%CI[-2.90,-0.08],p=.04)。然而,没有观察到显着的差异,在突起,软组织受累,眼运动性,和不利影响。
结论:硒可有效降低GO患者的CAS,改善眼睑孔径和GO-QOL。此外,它是安全的,具有良好的治疗意义。然而,需要进一步的研究来验证其长期疗效和安全性.
BACKGROUND: Selenium is a trace element crucial for thyroid function, and has potential therapeutic benefits in Graves\' orbitopathy (GO). Therefore, we aim to evaluate its efficacy and safety in GO patients to provide valuable insights into its role as a therapeutic option for this condition.
METHODS: Systematic
review and meta-analysis.
METHODS: GO Patients treated with selenium compared to placebo.
METHODS: Clinical activity score (CAS), Graves\' orbitopathy quality of life (GO-QOL), eye symptoms and signs, and adverse events.
RESULTS: Out of 1684 records screened, four randomised controlled trials were included. Selenium was superior at 6 months in lowering the CAS (MD = -1.27, 95% confidence interval [CI] [-1.68, -0.85], p < .0001]), improving total GO-QOL (RR = 2.54, 95% CI [1.69-3.81], p < .00001), and improving the visual and the psychological functioning scores (MD = 10.84, 95% CI [4.94-16.73], p = .003), (MD = 12.76, 95% CI [8.51-17.00], p < .00001) respectively. Similarly, it significantly improved these outcomes at 12 months. It also showed a significant decrease in the palpebral aperture at 6 months (MD = -1.49, 95% CI [-2.90, -0.08], p = .04). However, no significant differences were observed in proptosis, soft tissue involvement, ocular motility, and adverse effects.
CONCLUSIONS: Selenium is effective in reducing CAS and improving the palpebral aperture and GO-QOL in patients with GO. Additionally, it is safe and has promising therapeutic implications. However, further research is needed to validate its long-term efficacy and safety.