肿瘤坏死因子-α拮抗剂联合系统治疗的时机对重症多形红斑型药疹/中毒性表皮坏死松解症疗效的影响  

Influence of Timing of Tumor Necrosis Factor-αAntagonist Combined with Systemic Therapy on the Efficacy of SJS/TEN

作　　者：马梦兰 刘亚美 秦婷婷 曹育春[1] MA Menglan;LIU Yamei;QIN Tingting;CAO Yuchun(Department of Dermatology,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430030,China;Biliopancreatic Surgery,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430030,China)

机构地区：[1]华中科技大学同济医学院附属同济医院皮肤科,武汉430030 [2]华中科技大学同济医学院附属同济医院胆胰外科,武汉430030

出　　处：《医药导报》2023年第5期673-679,共7页Herald of Medicine

基　　金：国家自然科学基金资助项目(81974308)。

摘　　要：目的 探讨肿瘤坏死因子(TNF)-α拮抗剂使用时机对重症多形红斑型药疹(Steven-Johnson综合征,SJS)及中毒性表皮坏死松解症(TEN)联合治疗疗效的影响。方法 采用真实世界研究方法,收集华中科技大学同济医学院附属同济医院经TNF-α拮抗剂联合治疗的SJS/TEN患者的临床资料(本院病例组5例)及国内外文献报道的TNF-α拮抗剂联合治疗SJS/TEN的病例(文献病例组35例),2组患者临床特征差异无统计学意义(P>0.05)。患者按TNF-α拮抗剂应用时机分为:其他系统治疗失败后使用TNF-α拮抗剂组(A组28例)和TNF-α拮抗剂直接联合其他系统治疗组(B组12例),回顾性分析TNF-α拮抗剂使用时机对SJS/TEN联合治疗疗效的影响。结果 本院病例组经TNF-α拮抗剂联合治疗后反应良好,均在3 d内病情好转。B组患者TNF-α拮抗剂开始使用时间和皮损好转时间均短于A组(P<0.05)。结论 在SJS/TEN传统系统治疗的基础上,早期联合使用TNF-α拮抗剂有助于缩短皮损好转时间以快速改善病情。Objective To investigate the effect of timing of tumor necrosis factor(TNF)-αantagonist use on the efficacy of combined treatment of Stevens-Johnson syndrome(SJS)and toxic epidermal necrolysis(TEN).Methods Using real-world research methods,the clinical data of SJS/TEN patients treated with TNF-αantagonist in Tongji hospital(Tongji hospital case group,five patients)and in domestic and foreign literature reports(literature case group,35 patients)were collected.There was no significant difference in the clinical characteristics between our hospital case group and the literature case group.The patients were divided into two groups according to the application timing of TNF-αantagonist:the TNF-αantagonist group after other systemic therapy failed(group A,28 patients),and the TNF-αantagonist directly combined with other systemic therapy groups(group B,12 patients).The effects of the timing of TNF-αantagonist use on the efficacy of SJS/TEN combination therapy were retrospectively analyzed.Results Our hospital cases group responded well after combined treatment with TNF-αantagonists,and their condition improved within three days.The period before TNF-αantagonist use and the period before the lesions improved in group B were shorter than in group A(P<0.05).Conclusion Based on traditional systemic treatment of SJS/TEN,early combined use of TNF-αantagonists can help shorten the time of lesions to improve and ameliorate the disease rapidly.

关 键 词：肿瘤坏死因子-Α拮抗剂 重症多形红斑型药疹 中毒性表皮坏死症 

分 类 号：R986[医药卫生—药品] R758.25[医药卫生—药学]