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《Chongqing Medicine》 2017-13
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Protective effects of standard dose prednisone combined with glutamine on Graves ophthalmopathy after ~(131)I treatment

Zhang Qing;Shao Yi;Guan Yanxing;Liu Shaozheng;Chen Qingjie;Zhang Qing;Department of Nuclear Medicine,First Affiliated Hospital of Nanchang University;Department of Ophthalmology,First Affiliated Hospital of Nanchang University;  
Objective To investigate the protective effect of standard dose prednisone(starting dose about 0.4mg/kg bw)combined with glutamine(2g/d)for Graves′ophthalmopathy(GO)after ~(131)I treatment.Methods The prospective randomized controlled trial was performed and included 116 consecutive patients with mild-to-moderate GO or no active GO after ~(131)I treatment,but with high risk factors.The experimental group(59cases)started to take oral prednisone(0.44±0.13)mg/kg at 2datter theatment,meanwhile replenishing glutamine,and prednisone was gradually decreased by 5mg per 2weeks and stopped until 2months;the control group(57cases)received the initial dose prednisone(0.43±0.14)mg/kg without replenishing glutamine,and the rest was same as the experimental group.The GO change and prednisone adverse reactions in 2,4,6months after treatment were evaluated in the two groups.Results The baseline characteristics had no significant difference between the two groups.In comparison of the experimental group and control group after 6-month treatment,the CAS score was(2.8±0.8 vs.3.5±0.9),exophthalmos degree was(19.6±8.1)mmvs.(21.7±3.0)mm,eyelid width was(11.3±2.9)mmvs.(13.8±3.1)mm,the improvement degree in the experimental group except for degree was superior to the control group(P0.01).No new onset GO or deterioation occurred in the two groups;the experimental group had 42cases(71.2%)of GO improvement and 17cases(28.8%)of stability,while the control group had 39cases(68.4%)of GO improvement and 18cases(31.6%)of stability,and the curative effects had no sttistical difference between the two groups(P0.05).The side effects in the control group were more than those in the experimental group(63.1% vs.30.5%,P0.05).the body mass increase was more obvious[(3.8±1.8)kg vs.(1.4±1.2)kg,P0.01],and SBP and DBP in the two groups were slightly increased[(10±4)mm Hg vs.(9±5)mm Hg P0.05].Conclusion Using the initial dose of oral prednisone(about 0.4mg/kg)for 2months and simultaneously replenishing glutamine(2g/d)can effectively improve mild-moderate GO,and effectively reduce the adverse reactions of GC.However it is needed to extend the follow-up time to assess whether it can truly prevent the deterioration of GO,and to conduct a further study for the role of glutamine.
【Fund】: 江西省卫生和计划生育委员会基金(20141023)
【CateGory Index】: R581;R771.3
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【Citations】
Chinese Journal Full-text Database 5 Hits
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【Co-citations】
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1 Zhang Qing;Shao Yi;Guan Yanxing;Liu Shaozheng;Chen Qingjie;Zhang Qing;Department of Nuclear Medicine,First Affiliated Hospital of Nanchang University;Department of Ophthalmology,First Affiliated Hospital of Nanchang University;;Protective effects of standard dose prednisone combined with glutamine on Graves ophthalmopathy after ~(131)I treatment[J];重庆医学;2017-13
2 WANG Fenfen;LI Yanyan;Department of nutrition, Tianjin Huanhu Hospital;Department of nutrition, Liaocheng People's Hospital of Shandong Province;;Effect of Early Enteral Nutrition Combined With Glutamine on the Acute Stage of Server Stroke Patients[J];继续医学教育;2016-10
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