坏疽性脓皮病28例临床分析  

Analysis of 28 cases of pyoderma gangrenosum

作　　者：李瑾[1] 杨道秋[1] 翟志芳[2] 余佳[2] 宋志强[2] 

机构地区：[1]中国人民解放军第107医院皮肤科,山东烟台264000 [2]重庆第三军医大学附属西南医院皮肤科,重庆404100

出　　处：《临床皮肤科杂志》2017年第4期230-233,共4页Journal of Clinical Dermatology

摘　　要：目的 :探讨坏疽性脓皮病的临床特点、发病因素、并发疾病及治疗方法。方法 :回顾性分析2000年1月—2015年11月收治的28例坏疽性脓皮病患者的临床资料。结果:28例患者中,男女比例为1∶3.67,平均年龄46.62岁。42.8%并发原发性高血压病,其中有相当比例并发代谢综合征。皮损好发于双下肢。所有患者经口服糖皮质激素和免疫抑制剂,肌内注射重组人Ⅱ型肿瘤坏死因子受体抗体融合蛋白(商品名:益赛普)及局部治疗后,显效14例,有效12例,无效2例。结论:坏疽性脓皮病是由中性粒细胞的功能障碍、炎症介导和基因易感性共同参与的一类特发性疾病,生物制剂的出现给该病治疗提供了更多的选择,选药应考虑个体化方案。Objective： To investigate the clinical characteristics, etiological factors, concomitant diseases and treatment of py- oderma gangreuosum. Methods： We retrospectively analyzed 28 cases of pyoderma gangrenosum admitted to our hospital from January 2000 to November 2015. Results： Among the 28 patients, the ratio of males to females was 1 to 3.67, with an av- erage age of 46.62 years. 42.8% of the patients were complicated with primary hypertension, and a substantial portion of them were accompanied with the metabolic syndrome. Skin lesions often occurred on the lower limbs. Treatments with oral corticosteroids, immunosuppressants, intramuscular injection of Etanercept or local treatments resulted in marked improvement in 14 cases, improvement in 12 cases, and no improvement in 2 cases. Conclusions： Pyoderma gangrenosum is an idiopathic disease caused by neutrophil dysfunction together with inflammation and genetic susceptibility. The availability of biological a- gents gives physicians more therapeutic options for pyodenna gangrenosum, but individualized therapeutic regimen should be considered.

关 键 词：坏疽性脓皮病 临床分析 生物制剂 免疫抑制剂 

分 类 号：R758.29[医药卫生—皮肤病学与性病学]