301例大疱性类天疱疮住院患者临床回顾性分析  

Retrospective Clinical Analysis of 301 Hospitalized Patients with Bullous Pemphigus Vulgaris

作　　者：陈星会 穆亚楠 张逸 李东霞[1] Chen Xinghui;Mu Yanan;Zhang Yi;Li Dongxia(Affiliated Hospital of Inner Mongolia Medical University,Hohhot 010050,Inner Mongolia,China)

机构地区：[1]内蒙古医科大学附属医院,内蒙古自治区呼和浩特010050

出　　处：《中国中西医结合皮肤性病学杂志》2025年第1期20-25,共6页Chinese Journal of Dermatovenereology of Integrated Traditional and Western Medicine

基　　金：内蒙古自治区自然科学基金项目(编号:2023QN08039);内蒙古自治区高等学校“青年科技英才支持项目”(编号:NJYT24043)。

摘　　要：目的总结大疱性类天疱疮(BP)患者的临床表现、实验室检查及合并症。方法回顾性分析2015年1月—2023年5月在内蒙古医科大学附属医院皮肤科在住院301例患者的病例资料。结果301例患者中,男性174例(57.81%),女性127例(42.19%),平均年龄(70.55±12.88)岁;279例(92.69%)皮损为水疱或大疱,260例(86.38%)瘙痒是BP患者的常见症状,52例(17.28%)的患者存在黏膜受累;直接免疫荧光(DIF)的阳性率高于间接免疫荧光(IIF)检查,分别为84.06%和82.31%;患者病情严重程度与嗜酸性粒细胞升高相关,差异有统计学意义(P<0.05);黏膜受累与抗BP230抗体有关,黏膜受累患者的抗BP230抗体血清检出率显著较低,差异有统计学意义(P<0.05);133例(44.18%)BP合并心血管疾病,78例(25.91%)BP合并神经系统疾病,92例(30.56%)BP合并2型炎症性疾病。结论对于以水肿性红斑、丘疹和结节等不典型特征为初发表现的老年BP需要及早行组织病理学及免疫荧光检查;本研究中部分患者合并特应性疾病,部分伴有总免疫球蛋白E(IgE)及嗜酸性粒细胞计数增高,进一步证明BP的发病机制与2型炎性反应密切相关;BP好发于老年人,合并脑血管疾病者居多,需注意二者的相关性,避免神经系统疾病的危险诱发因素可能会降低BP的患病率。Objective In order to summarize the clinical manifestations,laboratory tests,and comorbidities of patients with bullous pemphigoid(BP).Method A retrospective analysis was conducted on the case data of 301 hospitalized patients in the dermatology department of Inner Mongolia medical university affiliated hospital from January 2015 to May 2023.Results Among the 301 patients,there were 174 males(57.81%)and 127 females(42.19%),with an average age of(70.55±12.88)years;279 cases(92.69%)had skin lesions as blisters or bullae,260 cases(86.38%)had itching as a common symptom in BP patients,and 52 cases(17.28%)had mucosal involvement.The positive rates of direct immunofluorescence(DIF)were higher than those of indirect immunofluorescence(IIF)examination,at 84.06%and 82.31%,respectively.The severity of the patient′s condition was correlated with elevated eosinophils,and the differences were statistically significant(P<0.05).Mucosal involvement was inversely associated with anti-BP230 antibodies,and the serum detection rate of anti-BP230 antibodies in patients with mucosal involvement was significantly lower,with a statistically significant difference(P<0.05);133 cases(44.18%)of BP complicated with cardiovascular disease,78 cases(25.91%)of BP complicated with neurological disease,and 92 cases(30.56%)of BP complicated with type 2 inflammatory disease.Conclusion For elderly BP with atypical features such as edematous erythema,papules,and nodules as initial manifestations,early histopathological and immunofluorescence examinations are necessary.In this study,some patients has comorbidities with atopic diseases,and some has increased total IgE and eosinophil counts,further proving that the pathogenesis of BP is closely related to type 2 inflammatory response.BP tends to occur in the elderly,and most of them are complicated with cerebrovascular diseases.Attention should be paid to the correlation between the two.Avoiding the risk factors of nervous system diseases may reduce the incidence rate of BP.

关 键 词：大疱性类天疱疮 回顾性分析 2型炎症性疾病 嗜酸性粒细胞 

分 类 号：R758.66[医药卫生—皮肤病学与性病学]