免疫抑制剂联合糖皮质激素治疗寻常型天疱疮疗效观察

目的:探讨环磷酰胺联合糖皮质激素治疗寻常型天疱疮的近、远期疗效。方法:收集近4年42例在我科住院经临床、病理确诊为寻常型天疱疮患者的详细资料,比较评估糖皮质激素联合硫唑嘌呤(AZP组)和糖皮质激素联合环磷酰胺(CTX组)治疗后的近、远期疗效。结果:近期疗效,AZP组痊愈率80.0%(16/20),未愈20.0%(4/20);CTX组痊愈率86.4%(19/22),未愈14.6%(3/22),两组相近,差异无统计学意义(P>0.05)。远期疗效,AZP组痊愈40.0%(8/20),控制35.0%(7/20),未控制25.0%(5/20);CTX组痊愈率81.8%(18/22),控制9.0%(2/22),未控制9.0%(2/22),两组差异有统计学意义(P<0.05)。结论:环磷酰胺静脉冲击(五日疗法)联合糖皮质激素疗法是治疗寻常型天疱疮的较好方法。

Efficacy of Cyclophosphamide Combining with Corticosteroid in the Treatment of Pemphigus Vulgaris

Objective:To investigate the short-term and long-term efficacy of intravenous cyclophosphamide(CTX) plus corticosteroid in the treatment of pemphigus vulgaris. Methods:Curative effect was evaluated in 42 patients with pemphigus vulgaris who were diagnosed by clinical manifestations and histopathology.The patients in group-one were treated with corticosteroid combining with azathioprine and the patients in group-two were treated with corticosteroid combining with cyclophosphamide(five days therapy).The whole patients were followed up for more than one year at least after discharging.Results: In terms of short-term efficacy,the complete remission rate was 80%(16/20) and partly remission rate was 20%(4/20) in the azathioprine group.In cyclophosphamide group,the complete remission rate was 86.4%(19/22) and partly remission rate was 14.6%((3/22)).There was no statistically significant between two groups(P>0.05).In terms of long-term efficacy,the complete remission rate was 40%(8/20),remission 35%(7/20) and partly remission 25%(5/20) in the azathioprine group,and complete remission 81.80%((18/22)),remission 9.00%(2/22) and partly remission 9.00%(2/22) in the corticosteroid group,the results were showed that statistically significant between the two groups(P<0.05).Conclusion:Intravenous cyclophosphamide(five days therapy) combining with corticosteroid was showed the good response in treatment of pemphigus vulgaris.