重症寻常型天疱疮60例临床分析  

Clinical retrospective analysis on severe pemphigus vulgaris: 60 cases

作　　者：周琛[1] 宁学玲[1] 陈勇[1] 李真树 ZHOU Chen;NING Xue-ling;CHEN Yong;LI Zhen-shu(Central People＇s Hospital of Zhanjiang,Zhanjiang 524037,China)

机构地区：[1]广东省湛江中心人民医院皮肤科,广东湛江524037

出　　处：《广东医科大学学报》2018年第4期428-430,共3页Journal of Guangdong Medical University

摘　　要：目的探讨重症寻常型天疱疮的临床特点及有效治疗方案。方法回顾性分析住院治疗的60例重症寻常型天疱疮患者的临床表现、入院时实验室及病理检查、治疗方案以及治疗过程中并发症的发生情况。结果 60例重症寻常型天疱疮住院患者均表现为松弛性水疱,其中52例(86.7%)有口腔黏膜受累,尼氏征阳性者60例(100.0%);入院时直接免疫荧光检查阳性49/55例(89.1%)。60例患者的甲强龙最大用量为(100.04±64.13)mg/d,甲强龙最大用量维持时间为(10.48±4.70)d,平均住院时间(26.13±12.18)d。60例中痊愈42例(70.0%),好转16例(26.7%),未愈2例(3.3%)。治疗过程中出现的不良反应主要有感染44例(73.3%),血糖异常20例(30.0%),消化道出血16例(26.7%)。结论重症寻常型天疱疮患者治疗首选系统使用甲强龙联合免疫抑制剂,但要警惕感染的发生。Objective To explore the clinical characteristics and effective therapeutic regimen of severe pemphigus vulgaris. The clinical manifestation, laboratory examination histopathologic examination at admission, therapeutic Methodsregimen and the incidence of the complications during the treatment of 60 cases with severe pemphigus vulgaris that hospitalized in our hospital to receive treatment were retrospectively analyzed. Results 60 hospitalized patients with severe pemphigus vulgaris showed loose blisters, of which there were 52 cases（86.7%） with oral mucosa involvement and 60（100.0%） with Nikolsky’s sign positive; 49 cases（89.1%） were detected positive in direct immunofluorescence test at admission. In 60 patients, the maximum dosage of methylprednisolone was（100.04±64.13） mg/d, the duration of the maximum dosage of methylprednisolone was（10.48±4.70） d and the average hospital stay was（26.13±12.18） d. Of the 60 cases, there were 42 cases cured（70.0%）, 16 cases improved（26.7%） and 2 cases not cured（3.3%）. Of the main adverse reactions during the treatment, there was infection in 44 cases（73.3%）, abnormal blood glucose in 20 cases（30.0%） and gastrointestinal bleeding in 16 cases（26.7%）. Conclusion The preferred system for the treatment of severe pemphigus vulgaris is methylprednisolone combined with immunosuppressant, but the incidence of infection shall be alerted.

关 键 词：重症寻常型天疱疮 糖皮质激素 免疫抑制剂 感染 

分 类 号：R758.66[医药卫生—皮肤病学与性病学]