目的:甲状腺眼病(TED)的治疗几十年来发生了重大变化。该研究旨在调查中国TED管理的当前临床实践。
方法:于2023年4月至5月进行了在线问卷调查。问卷涉及TED的诊断标准,多学科治疗(MDT)合作,和温和的治疗偏好,中度,严重的TED。
结果:共收集了289份问卷,内分泌学家165人,眼科医生124人。只有36.68%的参与者声称他们的机构中有TED的MDT临床模式。生物制剂的覆盖率约为10%或更低。明显低于西方国家。62.63%的参与者认为TED的发病率近年来有所增加。成像技术被广泛用于辅助诊断TED。然而,关于中国人群中突增的定义仍然存在争议。大多数医生控制了危险因素,并提供了人工泪液和眼镜的眼眶支持治疗。对于轻度活跃的TED,内分泌学家(39.39%)倾向于推荐单独治疗甲状腺功能亢进,眼科医生(43.55%)倾向于眼眶注射皮质类固醇.目前,中度至重度活动性TED最广泛使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受认可的二线治疗(43.60%)。
结论:该研究记录了中国目前关于TED管理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显着差异,保证管理优化。
UNASSIGNED: 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.
UNASSIGNED: 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.
UNASSIGNED: A total of 289 questionnaires were collected, with 165 from
endocrinologists and 124 from ophthalmologists. Only 36.7% of participants claimed there was an MDT clinical pattern for TED in their institutions. The coverage of biological agents was around 10% or lower. These were distinctly lower than in Western countries. About 62.6% of 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 the Chinese population. Most doctors managed risk factors and provided orbital supportive treatments of artificial tears and glasses. For mild active TED,
endocrinologists (39.4%) were inclined to recommend therapy for hyperthyroidism alone, while ophthalmologists (43.6%) preferred orbital corticosteroid injections. Currently, the most widely used treatment for moderate to severe active TED was high-dose intravenous corticosteroid (94.8%), while orbital radiotherapy combined with immunosuppressive agents was the most recognized second-line therapy (43.6%).
UNASSIGNED: The study documented the consistency and differences between current clinical practices in the management of TED in China and the recently updated guidelines. There was a remarkable difference between ophthalmology and endocrinology departments, warranting management optimization.