大疱性类天疱疮黏膜受累患者的临床特点分析  

Clinical Characteristics of Bullous Pemphigoid Patients with Mucosal Involvement

作　　者：金张思 陶笑然 王再兴[1] JIN Zhangsi;TAO Xiaoran;WANG Zaixing(Department of Dermatovenereology,the First Affiliated Hospital of Anhui Medical University,Hefei 230022,China)

机构地区：[1]安徽医科大学第一附属医院皮肤性病科,安徽合肥230022

出　　处：《中国皮肤性病学杂志》2024年第2期163-167,共5页The Chinese Journal of Dermatovenereology

基　　金：安徽省重点研究与开发计划项目(2022e07020041)。

摘　　要：目的存在黏膜受累的大疱性类天疱疮患者的特征尚未明确,描述和分析黏膜病变亚组的临床特征具有重要临床意义。方法回顾性分析2019年8月—2023年1月于安徽医科大学第一附属医院住院治疗的187例大疱性类天疱疮患者,根据是否存在黏膜病变分为两组,采用单因素和多因素分析黏膜受累患者的临床特点。结果37例(19.79%)患者存在黏膜受累,口腔最常见。相较于无黏膜受累患者,黏膜受累亚组头面颈及手足皮疹更常见,外周血嗜酸性粒细胞计数和百分比下降,中性粒细胞百分比升高,癌症风险、直接免疫荧光C3沉积阳性率高,差异有统计学意义(P<0.05)。两组之间性别、年龄、躯干和四肢部位皮疹分布、抗BP180和间接免疫荧光抗体阳性率、白细胞计数、C-反应蛋白、降钙素原、白介素-6水平差异无统计学意义。多因素分析示手足皮疹和外周血嗜酸性粒细胞百分比下降与黏膜受累相关。结论表现为黏膜受累的大疱性类天疱疮患者亚组存在显著特征,尤其是患者的皮损分布特点及外周血嗜酸性粒细胞水平对黏膜病变具有重要提示意义,为疾病诊疗提供依据。Objective The characteristics of bullous pemphigoid patients with mucosal involvement are not clear.It is great significance to analyze the clinical characteristics of patients with mucosal involvement.Methods Retrospective analysis was made in 187 patients with bullous pemphigoid who were hospitalized in the First Affiliated Hospital of Anhui Medical University from August 2019 to January 2023.They were divided into two groups according to whether there were mucosal involvement.Univariate and multivariate analysis were used to analyze the features of patients with mucosal involvement.Results Mucosal involvement occurred in 37 cases(19.79%).Oral mucosa was the most common.Compared with patients without mucosal involvement,skin rash on head,face,neck,hands and feet were more common in patients with mucosal involvement.In addition,there were lower count and percentage of eosinophils,higher percentage of neutrophils in peripheral blood,higher cancer risk and positive rate of direct immunofluorescence C3 deposition in mucosal involvement subgroup(P<0.05).There was no statistical difference between the two groups in gender,age,distribution of rash on trunk and limbs,positive rate of anti⁃BP180 and immunofluorescence antibody,white blood cell count,C⁃reactive protein,procalcitonin and interleukin⁃6 levels.Multivariate analysis suggested rash on hands and feet and decreased percentage of eosinophils were relevant with mucosal involvement.Conclusion Patients in mucosal involvement subgroup have significant characteristics.The distribution characteristics of skin lesions and eosinophil levels in peripheral blood of patients have important implications for mucosal lesions,which provide a basis for disease diagnosis and treatment.

关 键 词：大疱性类天疱疮 黏膜受累 临床特点 嗜酸性粒细胞 

分 类 号：R758.66[医药卫生—皮肤病学与性病学]