沙利度胺治疗天疱疮口腔黏膜损害的疗效及安全性  

Efficacy and safety of thalidomide in the treatment of oral mucosal lesions of pemphigus

作　　者：常慧玲 陈喜雪[1] 朱学骏[1] 王明悦[1] CHANG Hui-ling;CHEN Xi-xue;ZHU Xue-jun;WANG Ming-yue(Department of Dermatology,Peking University First Hospital,Beijing 100034,China)

机构地区：[1]北京大学第一医院皮肤科,北京100034

出　　处：《临床皮肤科杂志》2020年第9期518-520,共3页Journal of Clinical Dermatology

基　　金：北京市自然科学基金(7172214)资助项目。

摘　　要：目的:探讨沙利度胺治疗天疱疮口腔黏膜损害的有效性及安全性。方法:回顾性分析北京大学第一医院皮肤科2014年12月—2018年6月使用沙利度胺治疗仅有口腔黏膜症状的寻常型天疱疮及副肿瘤性天疱疮患者共19例。结果:沙利度胺治疗寻常型天疱疮及副肿瘤性天疱疮患者口腔黏膜症状的有效率分别为84.6%及66.6%。寻常型天疱疮患者在沙利度胺治疗前后的自身免疫性疱病严重程度评分(autoimmune bullous skin disorder intensity score,ABSIS)中口腔黏膜损害严重程度评分中位数分别为2分及0分(P<0.05),副肿瘤性天疱疮患者在沙利度胺治疗前后的ABSIS中口腔黏膜损害严重程度评分中位数分别为3分及1.5分(P>0.05);沙利度胺治疗前后5例天疱疮患者桥粒核心糖蛋白3抗体滴度的中位数分别为100.64 kU/L及81.88kU/L。19例患者中有7例(36.8%)出现不同程度的不良反应,其中面部或四肢麻木的外周神经炎发生率最高(21.1%),停药后症状完全消失。结论:沙利度胺治疗寻常型天疱疮患者的黏膜损害有效,是目前有效性及安全性较高的天疱疮口腔黏膜损害辅助治疗药物。Objective:To evaluate the efficacy and safety of thalidomide in the treatment of oral mucosal lesions of pemphigus.Methods:The patients of pemphigus vulgaris and paraneoplastic pemphigus with only oral mucosal symptoms were treated with thalidomide in the Department of Dermatology at Peking University First Hospital from December 2014 to June 2018.Results:The effective rates of thalidomide in the treatment of pemphigus vulgaris and paraneoplastic pemphigus were 84.6%and 66.6%,respectively.The median ABSIS scores of oral mucosal involvement in patients with pemphigus vulgaris before and after thalidomide treatment were 2 and 0,respectively(P<0.05).And the median ABSIS scores in patients with paraneoplastic pemphigus before and after treatment were 3 and 1.5,respectively(P>0.05).The median values of desmoglein 3 antibodies in 5 pemphigus patients before and after thalidomide treatment were 100.64 kU/L and 81.88 kU/L,respectively.Among the 19 patients,7(36.8%)had adverse reactions.The incidence of peripheral neuritis with facial or limb numbness was the highest(21.1%).The symptoms of adverse reactions disappeared completely after withdrawal of the drug.Conclusion:Thalidomide has statistically significant effects in treating oral mucosal lesions of pemphigus vulgaris and thus it is an effective and safe adjuvant drug for pemphigus vulgaris.

关 键 词：天疱疮 寻常型 天疱疮 副肿瘤性 沙利度胺 自身免疫性疱病严重程度评分 桥粒核心糖蛋白3抗体 

分 类 号：R758.66[医药卫生—皮肤病学与性病学]