红皮病性银屑病198例临床回顾性分析  

A clinical analysis of 198 cases of erythrodermic psoriasis

作　　者：严红霞[1] 史冬梅[1,2] 汤洁[2] 崔盘根[2] 林麟[2] 王千秋[2] 苏晓红[2] 吴余乐[2] 陈崑[2] 刘毅[2] 齐淑贞[2] 吴秋菊[2] 陈浩[2] 鞠梅[2] 李筱芳[2] 陈敏[2] 

机构地区：[1]济宁市第一人民医院,272001 [2]中国医学科学院皮肤病研究所

出　　处：《实用皮肤病学杂志》2016年第1期1-3,共3页Journal of Practical Dermatology

基　　金：卫生公益性行业科研专项经费资助项目(201002016)

摘　　要：目的分析红皮病性银屑病的诱发因素、临床特点、治疗方法和疗效。方法回顾性分析2010年1月—2013年12月收治的红皮病性银屑病患者的临床资料。结果 198例中男女之比为3∶1,平均发病年龄为45岁,从其他类型银屑病转化为红皮病性银屑病176例(88.8%),平均病程14.63年;其余22例患者的平均病程为5.6年。主要诱发因素为感染、滥用糖皮质激素和突然停药。174例(87.9%)并发甲损害,14例(7.1%)并发脓疱,16例(8.1%)关节受累,30例(15.1%)伴发热。根据病情和治疗史选择联合治疗方案,163例患者分5组治疗:复方甘草酸二铵联合阿奇霉素药物(14例)、病情严重的患者在此治疗基础上分别加用雷公藤多苷(15例)、阿维A(61例)、雷公藤多苷+阿维A(63例)、雷公藤多苷+阿维A+甲氨蝶呤(10例),各治疗组有效率分别为85.7%、86.7%、90.1%、92%和90%。结论红皮病性银屑病主要由其他类型银屑病转化而来,控制诱因和规范化治疗有助于减少红皮病性银屑病的发病率。联合治疗可以提高病情严重患者的疗效。Objective To analyze the clinical features, inducing factors, treatment methods and their therapeutic efficiency of erythrodermic psoriasis（EP）. Methods The clinical data of 198 inpatients with EP collected at the institute from January 2010 to December 2013 were analyzed retrospectively. Results For these patients, the ratio of male to female was 3：1. Average age was 45 years. The average interval between the onset of psoriasis and first erythrodermic flare was 14.63 years. The main inducing factors were infection, abuse of glucocorticoids and irregular drug withdrawal. One hundred and seventy-four patients had fingernail damage, 14（7.1%） had pustules, 16（8.1%） had injury of joint; and 30（15.1%） had fever. The efficiency rate of tripterygium glycosides, acitretin, acitretin combined with tripterygium glycosides, acitretin combined with tripterygium glycosides and methotrexate（all the four groups presented above were combined with both azithromycin and compound diammonium glycyrrhizinate） and azithromycin combined with compound diammonium glycyrrhizinate alone had no significant difference between the groups. The efficiency rate of each group was 85.7%, 86.7%, 90.1%, 92% and 90% respectively. Conclusion EP mainly develops from other types of psoriasis, controlling of the inducing factors and standardized treatment can help reduce the incidence of EP. Combination therapy can improve the efficiency of serious EP.

关 键 词：银屑病 红皮病性 临床回顾性分析 

分 类 号：R758.63[医药卫生—皮肤病学与性病学]