SCORTEN评分对中毒性表皮坏死松解症和Stevens-Johnson综合征评估分析  

Prognostic accuracy of the SCORTEN scoring system in patients with toxic epidermal necrolysis or Stevens-Johnson syndrome

作　　者：王昱璐 左亚刚[1] 刘洁[1] 刘跃华[1] 李丽[1] 孙秋宁[1] 晋红中[1] 

机构地区：[1]中国医学科学院北京协和医学院北京协和医院皮肤科,北京100730

出　　处：《中华皮肤科杂志》2016年第9期651-653,共3页Chinese Journal of Dermatology

基　　金：基金项目：国家自然科学基金（81071301）;北京市自然科学基金（7132203）

摘　　要：目的 分析SCORTEN评分对中毒性表皮坏死松解症和Stevens-Johnson综合征患者预后评估的准确性。方法 回顾性分析1992年4月至2014年3月期间在北京协和医院收治的中毒性表皮坏死松解症和Stevens-Johnson综合征39例，其中死亡病例13例，按照年龄分层1∶2匹配诊断明确好转出院26例。39例患者用SCORTEN评分系统评分，计算预期死亡数，比较39例各级分层的预期死亡数与实际死亡数，绘制受试者工作特征曲线（ROC曲线），评估SCORTEN评分的判断力。结果 39例患者中，按SCORTEN评分系统评为1分15例，2分14例，3分6例，4分4例，总预期死亡6.808例，实际死亡13例。 每个积分层预期死亡数与实际死亡数差异无统计学意义。SCORTEN评分系统的ROC曲线下面积 = 0.832 8，表明有较好的预测能力。结论 SCORTEN评分系统可在早期对中毒性表皮坏死松解症和Stevens-Johnson综合征患者死亡率作出评估。Objective To evaluate the prognostic accuracy of the score of toxic epidermal necrolysis （SCORTEN） scoring system in patients with toxic epidermal necrolysis （TEN） or Stevens-Johnson syndrome （SJS）. Methods Clinical data were collected from 39 patients with SJS/TEN hospitalized in Peking Union Medical College Hospital during April 1992 and March 2014, and retrospectively analyzed. Among the 39 patients, 13 had died, and the other 26 patients, who were matched to the dead patients in a ratio of 2∶1 for age, all had a definite diagnosis and were discharged with improved conditions. The SCORTEN scoring system was used to evaluate the 39 patients with SJS/TEN and calculate expected mortality. The expected mortality and actual mortality were compared between different groups stratified by age in the 39 patients. The receiver operating characteristic （ROC） curve was drawn to assess the prognostic accuracy of the SCORTEN scoring system. Results According to the SCORTEN scoring system, 15 out of the 39 patients scored 1 point, 14 scored 2 points, 6 scored 3 points, and 4 scored 4 points. The total number of expected deaths was 6.808, while that of actual deaths was 13. There was no significant difference between the expected mortality and actual mortality in every SCORTEN score-based group. The area under curve （AUC） was 0.832 8, indicating a good predictive ability of the SCORTEN scoring system. Conclusion The SCORTEN scoring system can predict mortality in TEN/SJS patients at early stage.

关 键 词：表皮坏死松解症 中毒性 药疹 STEVENS-JOHNSON综合征 SCORTEN评分 

分 类 号：R758.2[医药卫生—皮肤病学与性病学]