85例结节性红斑患者复发因素分析  

Analysis of relapse factors on 85 cases of erythema nodosum

作　　者：赖忆玲 廖明意 温燕华 郑威 叶小英 LAI Yi-ing;LIAO Ming-yi;WEN Yan-hua;ZHENG Wei;YE Xiao-ying(The First Clinical Medical School of Gannan Medical University,Ganzhou,Jiangxi 341000;Department of Blood Transfusion,The First Affiliated Hospital of Gannan Medical University,Ganzhou,Jiangxi 341000;Department of Dermatology and Venereology,Candidate Branch of National Clinical Research Centre for Skin and Immune Diseases,The First Affiliated Hospital of Gannan Medical University,Ganzhou,Jiangxi 341000)

机构地区：[1]赣南医科大学第一临床医学院,江西赣州341000 [2]赣南医科大学第一附属医院输血科,江西赣州341000 [3]赣南医科大学第一附属医院皮肤科,国家皮肤与免疫疾病临床医学研究中心分中心,银屑病规范化诊疗中心,江西赣州341000

出　　处：《赣南医学院学报》2024年第3期244-247,254,共5页JOURNAL OF GANNAN MEDICAL UNIVERSITY

基　　金：赣州市指导性科技计划项目(GZ2017ZSF002)。

摘　　要：目的:探讨结节性红斑(Erythema nodosum,EN)复发的有关因素。方法:将2016年1月—2022年6月在赣南医科大学第一附属医院诊断为EN的患者分为复发组(26例)和未复发组(59例),对其临床资料进行回顾性对比分析。采用χ^(2)检验及t检验比较2组临床特征及实验室检验指标,并对其进行多因素Logistic回归分析;比较EN患者结核菌素纯蛋白衍生物(Purified protein derivative of tuberculin,PPD)试验与结核感染T细胞斑点试验(T cell spot test of tuberculosis infection,T-SPOT.TB)的结果。结果:EN的复发与发病部位(χ^(2)=8.137,P=0.004)、C反应蛋白(χ^(2)=5.412,P=0.020)、中性粒细胞数目(χ^(2)=8.485,P=0.014)有关;多因素Logistic回归分析显示,发病部位(OR=5.394,95%CI=1.744~16.689)、C反应蛋白偏高(OR=3.383,95%CI=1.006~11.375)为EN复发的独立危险因素(P<0.05);T-SPOT.TB结果阳性时抗结核治疗的复发率(10%)比PPD试验结果阳性的复发率(81.4%)低(P<0.05)。结论:EN的复发与发病部位、C反应蛋白、中性粒细胞数目有关;影响EN复发的独立危险因素为发病部位、C反应蛋白;T-SPOT.TB与PPD试验联合应用有助于发现EN患者的结核感染,2项结果阳性时抗结核治疗的EN复发率较低。Objective:To investigate the factors related to the recurrence of erythema nodosum(EN).Methods:The patients with erythema nodosum who were admitted to the inpatient department of The First Affiliated Hospital of Gannan Medical University from January 2016 to June 2022 and discharged with the diagnosis of erythema nodosum were included,They were divided into recurrent group(26 cases)and non-recurrent group(59 cases),and their clinical data were retrospectively compared and analyzed.χ^(2) test and t test were adopted,to compare the clinical characteristics and laboratory test indicators,and multiple factor Logistic regression analysis was conducted.The results of purified protein derivative of tuberculin(PPD)and T cell spot test of tuberculosis infection(T-SPOT.TB)were compared.Results:The recurrence of EN was related to the location of the disease(χ^(2)=8.137,P=0.004),C-reactive protein(χ^(2)=5.412,P=0.020),and the number of neutrophils(χ^(2)=8.485,P=0.014).Multivariate Logistic regression analysis showed that the location of the disease(OR=5.394,95%CI=1.744-16.689)and high C-reactive protein(OR=3.383,95%CI=1.006-11.375)were independent risk factors for the recurrence of EN(P<0.05).The recurrence rate of anti-tuberculosis treatment in patients with positive T-SPOT.TB results(10%)was lower than that in patients with positive PPD test results(81.4%)(P<0.05).Conclusion:The recurrence of EN is related to the site of the disease,C-reactive protein and the number of neutrophils.The independent risk factors affecting the recurrence of EN are the location of the disease and C-reactive protein.The combination of T-SPOT.TB and PPD test is helpful to detect tuberculosis infection in patients with EN.The EN recurrence rate of anti-tuberculosis treatment is lower when the two results are positive.

关 键 词：结节性红斑 结核 复发 结核感染T细胞斑点试验 结核菌素纯蛋白衍生物试验 

分 类 号：R758.61[医药卫生—皮肤病学与性病学]