重症多形红斑型药疹52例和中毒性表皮坏死松解症31例回顾性分析  

A Retrospective Study on 52cases of Stevens Johnson Syndrome and 31cases of Toxic Epidermal Necrolysis

作　　者：平晓芳[1] 卢桂玲[1] 

机构地区：[1]天津医科大学研究生院,天津300070

出　　处：《中国皮肤性病学杂志》2013年第2期148-150,共3页The Chinese Journal of Dermatovenereology

摘　　要：目的比较重症多形红斑(SJS)和中毒性表皮坏死松解症(TEN)的临床特征和实验室检查指标的差异。方法对2000年7月-2012年2月本院收治的83例SJS和TEN患者的临床资料进行回顾性分析,用SCORTEN评分系统对疾病的严重程度和病人的预后进行评估。结果引起SJS和TEN的药物以抗生素为主,其次是非甾体类抗炎药。TEN组的电解质异常的例数明显高于SJS组(P<0.05);肝功能损害是SJS和TEN最常见的并发症;SJS组和TEN组共有81例给予系统用糖皮质激素治疗,2例仅用人免疫球蛋白治疗,SJS组7例和TEN组15例给予激素联合人免疫球蛋白治疗。SCORTEN评分超过3分的有4例,其中1例死亡。结论抗生素是引起重症药疹最常见的药物,系统应用糖皮质激素尤其是联合人免疫球蛋白治疗可能是降低SJS和TEN死亡率的有效手段之一。Objective To distinguish the differences of the clinical characteristics and chemical tests between SJS and TEN. Methods Retrospective analysis of clinical data was made in 83 cases of SJS and TEN from July 2000 to Feb. 2012. The severity and prognosis of these patients can be evaluated by SCORTEN scoring sys- tem. Results The major causative drugs were antibiotics, secondly was nonsteroidal anti-inflammatory drugs（NSAIDs）. The cases of electrolyte disturbance in TEN were significantly higher than those of SJS（ P 〈0.05）. Hepatitis was the most common organ damage in both SJS and TEN;81 in 83 cases with SJS or TEN were treated with systemic corticosteroids, and 2 cases were treated with immunoglobulin alone,7cases of SJS and 15cases of TEN were treated with immunoglobulin combined with corticosteroid. There were 4 ca- ses SCORTEN score ≥ 3,1 case death. Conclusion Antibiotics were the most common causative drugs, systemic therapy with corticosteroids especially treated with combined therapy of immunoglobulin and cortico- steroid may be one of the effective measures for reducing mortalities of SJS and TEN.

关 键 词：重症多形红斑 中毒性表皮坏死松解症 I临床特征 实验室指标 并发症 

分 类 号：R758.25[医药卫生—皮肤病学与性病学]