糖皮质激素单用或联合丙种球蛋白治疗SJS/TEN的临床疗效：基于SCORTEN评分的回顾性分析  

Efficacy of single corticosteroid or with Intravenous immunoglobulin in the treatment of SJS/TEN: a SCORTEN-based retrospective analysis

作　　者：韩永智[1] 韩芳[2] 赵文伟 司徒欣欣[1] 

机构地区：[1]广东省人民医院、广东省医学科学院皮肤科,广州510080 [2]广州市第一人民医院病案统计科,广州510180 [3]西安大兴医院皮肤科,西安710016

出　　处：《广州医药》2016年第2期44-47,共4页Guangzhou Medical Journal

摘　　要：目的评估SCORTEN评分与我国SJS/TEN患者疾病严重程度的一致性,比较单用糖皮质激素(TCS)和糖皮质激素—丙种球蛋白冲击(TCS-IVIG)联合治疗SJS/TEN的临床效果。方法收集我院2005年6月—2015年5月住院的SJS/TEN患者,计算每例患者的SCORTEN评分,采用Hosmer-Lemeshow检验评估SCORTEN模型的预期死亡率和实际死亡率的拟合度;比较单用TCS和TCS-IVIG联合治疗的患者在疾病严重程度、住院天数、疾病控制时间和死亡率方面的差异。结果 SCORTEN模型的预期死亡率和实际死亡率之间的拟合度良好(各组P值均大于0.5);二组患者在住院天数、疾病控制时间和死亡率方面的差异没有统计学意义(P分别为0.105,0.910,0.701),但TCS-IVIG组患者的疾病严重程度显著高于TCS组(P=0.017)。结论 SCORTEN评分可以用于评估国内SJS/TEN患者的病情严重程度,并预测患者预后;与单用TCS相比,联合IVIG有助于提高重症SJS/TEN患者的救治效果。Objectivs To evaluate the performance of SCORTEN in severity of SJS/TEN in China,and to compare the efficacy of corticosteroid therapy（ TCS） and intravenous immunoglobulin combined therapy（ TCS-IVIG）. Methods Collected retrospectively the data of the SJS / TEN patients from June 2005 to May 2015 in our hospital. Hosmer-Lemeshow statistic were used to assess SCORTEN model calibration. And the differences between TCS group and TCS-IVIG group were compared in severity-of-illness,length of hospitalization,disease control time and mortality. Results A good calibration were found in all groups（ all P 0. 5）. Although the severity-of-illness in the TCS-IVIG group was significantly higher than that in the TCS group（ P = 0. 017）,there was no statistical significance between the two groups in length of hospitalization,disease control time and mortality（ P = 0. 105,0. 910,0. 701,respectively）. Conclusion SCORTEN can be used to assess the severity-of-illness in Chinese patients with SJS / TEN and to predict the prognosis. Compared with single TCS,It could improve the clinical outcomes of patients with severe SJS / TEN combined with IVIG.

关 键 词：STEVENS-JOHNSON综合征 中毒性表皮坏死综合征 SCORTEN 临床疗效 

分 类 号：R751[医药卫生—皮肤病学与性病学]