갑상선 안병증에서 병의 경과에 영향을 미치는 요인들에 관한 연구
A Study of Factors Related to the Course of Graves’ Ophthalmopathy
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목적: 갑상선 안병증에서 병의 경과에 영향을 미치는 위험인자에 대해 알아보고자 하였다. 대상과 방법: 2006년 3월에서 2008년 8월까지 본원에서 갑상선 안병증을 진단받은 125명을 대상으로 CAS (Clinical Activity Score)와 NOPSECS classification에 따라 경한 경과를 보이는 그룹(mild group)과 심한 경과를 보이는 그룹(severe group)으로 분류하여 후향 적으로 연구하고 이를 통계학적으로 분석하였다. 결과: 여성(p=0.04), 나이(p=0.0004), 흡연력(p=0.003), TSI 수치(p=0.009)는 진단 시 심한 갑상선 안병증의 위험인자로 생각된다. 또한 진단 후 총 3회의 경과 관찰에서 모두 TSI 수치는 심한 경과를 보이는 그룹(severe group)에서 더 높은 경향을 보였다(진단 후 3, 6, 9개월: p=0.003, p=0.002, p=0.006). 결론: 흡연력, 나이, 여성, TSI 수치는 갑상선 안병증의 진단 시 중증도를 예측할 수 있는 위험인자로 생각되고 이 중 TSI 수치는 경과 관찰 기간 동안 병의 중증도를 반영하는 유용한 지표로 여겨진다.
Abstract
Purpose: To investigate the risk factors related to the course of Graves’ ophthalmopathy (GO). Methods: This is a retrospective study of 125 patients who were referred to our clinic and diagnosed with GO from March 2006 to August 2008. Ophthalmic examinations and a thyroid function test including TSI were performed at the time of diagnosis and every 3 months after diagnosis. All patients were classified as having a mild or severe course of GO, according to Clinical Activity Score (CAS) and NOSPECS classifications. Results: This statistical analysis of each group revealed that female sex (p = 0.04), age (p = 0.0004), smoking (p = 0.003), and high TSI level (p = 0.009) were significant factors for severe course of GO at the time of diagnosis. TSI levels at each of the 3 visits during the follow-up were significantly higher in patients with a severe course of GO, as compared to patients with a mild course of GO (first visit: p = 0.003, second visit: p = 0.002, third visit: p = 0.006). Conclusions: Female sex, age, smoking, and high TSI level appear to be the risk factors that can predict the severity of GO at the time of diagnosis. Additionally, the TSI level can reflect the severity of GO during the follow-up periods.
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