天疱疮149例临床分析

目的 总结天疱疮发病的临床规律和特点,探寻最佳治疗方案,为科学治疗天疱疮和改善预后提供依据。方法 回顾性分析1994年4月-2011年1月昆明医学院附属二院皮肤科收治的149例天疱疮住院患者的临床资料。结果 男71例,女78例;平均年龄(46.24±13.10)岁。轻症26例,中症58例,重症65例。轻、中和重症天疱疮患者激素治疗初始用量分别为(42.15±11.60)mg,(76.94±25.80mg)和(104.02±14.31)mg(P<0.05);重症患者中激素联合免疫抑制剂组病情缓解率(82.05%,32/39)高于激素组(57.69%,15/26,P<0.05)。结论 天疱疮好发于中年人,无性别差异。口腔/头皮受累常提示病情严重;激素用量根据病情严重程度而定,激素联合免疫抑制剂治疗优于单用激素;感染是其主要并发症;疾病类型、病情严重程度及是否合并低蛋白血症是影响预后的重要因素。

Clinical Analysis of 149 Cases with Pemphigus

Objective To summarize the general rule and characteristics of pemphigus,to investigate the best therapeutic scheme,and try to improve the treatment and prognosis of pemphigus.Methods The clinical data of 149 patients with pemphigus in the Department of Dermatology,the 2nd Affiliated Hospital of Kunming Medical University from Apr.1994 to Jan.2011 were analyzed retrospectively.Results In 149 cases,71 cases were male,78 cases were female;The average age was(46.24±13.10) years,mild pemphigus 26 cases,moderate 58 cases,severe 65 cases;the initial steroid dose of different severity were(42.15±11.60)mg,(76.94±25.80)mg and(104.02±14.31)mg respectively(P<0.05);the remission rate of group A(82.05%,32/39) was below the group B(57.69%,15/26,P<0.05).Conclusion Pemphigus often occurs in middle-aged person without sex difference.Lesions occur in the oral and/or on scalp often indicated gravity of illness;The severity degree determined dose of steroid,It was more effectively used steroid with immunosuppressive agent than used steroid alone;Infection was main complication;Type,severity degree and hypoproteinemia were very important for prognosis.