天疱疮患者甲损害的临床特征及其与病情严重程度的相关性分析  

The clinical characteristics of nail involvement in pemphigus patients and the correlation between nail involvement and the severity of pemphigus

作　　者：胡凤侠[1] 梁俊琴[1] 康晓静[1] Hu Fengxia;Liang Junqin;Kang Xiaojing(Department of Dermatology and Venereology,People′s Hospital of Xinjiang Uygur Autonomous Region,Xinjiang Clinical Research Center For Dermatologic Diseases,Xinjiang Key Laboratory of Dermatology Research,Urumqi 830001,China)

机构地区：[1]新疆维吾尔自治区人民医院皮肤性病科,新疆皮肤病临床医学研究中心,新疆皮肤病研究重点实验室,乌鲁木齐830001

出　　处：《中国医师杂志》2023年第1期11-15,共5页Journal of Chinese Physician

基　　金：国家自然科学基金(81960564,82260621);新疆维吾尔自治区人民医院院内项目(20220136)。

摘　　要：目的分析天疱疮患者甲损害的临床特征,并分析甲损害与天疱疮病情严重程度的相关性。方法回顾性分析2011年1月至2019年8月新疆维吾尔自治区人民医院收治的23例天疱疮甲损害患者的临床资料,总结天疱疮甲损害的表现形式,分析不同性别天疱疮合并甲损害患者的病甲数量差异、指甲和趾甲中病甲分布差异,并对所有患者抗桥粒芯糖蛋白抗体滴度进行检测,分析天疱疮患者甲损害与疾病严重程度及病程的关系。结果23例天疱疮患者(男14例、女9例)共发生病甲132个,其中男性66个,女性66个,指甲82个,趾甲50个,甲损害表现形式共有10种,其中以慢性甲沟炎最为常见。不同性别天疱疮合并甲损害患者的病甲数量差异具有统计学意义(χ2=9.183,P<0.001)。天疱疮合并甲损害患者的指甲和趾甲中病甲分布差异有统计学意义(χ2=10.880,P<0.001)。23例患者中仅抗桥粒芯糖蛋白抗体1(dsg1)阳性者3例,仅抗桥粒芯糖蛋白抗体3(dsg3)阳性者1例,有19例患者同时出现dsg1和dsg3阳性。对14例患者甲损害前后dsg1、3滴度进行比较,显示天疱疮患者出现甲损害后抗桥粒芯糖蛋白抗体滴度均较前明显升高。23例患者中13例患者在初发天疱疮时即出现了甲损害,甲损害发生在发病前的6周至发病后4周。10例患者在疾病复发时出现了甲损害,甲损害出现在水疱发生前4周内或与水疱同时发生。结论女性天疱疮合并甲损害患者的人均病甲数量明显高于男性患者,并以指甲损害多见。天疱疮出现甲损害时抗桥粒芯糖蛋白抗体滴度处在较高水平,病情严重,甲受累与病情严重程度呈正相关,并且可延长病程。Objective To analyze the clinical characteristics of nail involvement in patients with pemphigus and the correlation between nail damage and the severity of pemphigus.Methods The clinical data of 23 patients with pemphigus combined with nail damage admitted to the People′s Hospital of Xinjiang Uygur Autonomous Region from January 2011 to August 2019 were retrospectively analyzed,the manifestations of pemphigus combined with nail damage were summarized.The nail damage number of patients with pemphigus complicated with nail damage of different genders were analyzed,as well as the distribution of nail damage in nail and toenail.The titer of anti-desmocoglycoprotein(dsg)antibody was detected in all patients.The relationship between nail damage and disease severity and course in pemphigus patients was analyzed.Results A total of 132 damage nails were found in 23 patients(14 males and 9 females)with pemphigus,including 66 nails in male,66 nails in female,82 nails and 50 toenails.There were 10 forms of nail damage,of which chronic paronychia was the most common.The number of damage nails between different genders in pemphigus patients was statistically significant(χ2=9.183,P<0.001).The distribution of nail and toenail damage in pemphigus patients was statistically significant(χ2=10.880,P<0.001).Of the 23 patients,only 3 were positive for dsg1 and 1 was positive for dsg3.There were 19 patients with both positive for dsg1 and dsg3.The titers of dsg1 and dsg3 were compared in 14 patients before and after nail damage.The results showed that the titers of anti-dsg antibody in pemphigus patients after nail damage were significantly higher than before.Thirteen of the 23 patients had nail damage at the time of the initial onset of pemphigus.The nail damage occurred from 6 weeks before the onset to 4 weeks after the onset.The nail damage occurred in 10 patients when the disease recurred.The nail damage occurred within 4 weeks before or at the same time with the blister.Conclusions The number of damage nails per capita in fem

关 键 词：天疱疮 指(趾)甲疾病 抗桥粒芯糖蛋白抗体 疾病严重程度 

分 类 号：R758.66[医药卫生—皮肤病学与性病学]