84例天疱疮患者临床疗效分析和预后观察

摘要] 目的 总结天疱疮患者的治疗方案，分析其治疗效果及预后。方法 回顾分析84例天疱疮患者的临床资料，治疗药物均以糖皮质激素（以下简称激素）为主，45例患者同时加用免疫抑制剂（其中3例因治疗效果差进行了自体外周血干细胞移植），观察激素用量、治疗效果、副作用以及预后情况。结果 重症组患者激素初始量高于中症组患者；激素联合免疫抑制剂组治疗效果优于激素组；随访患者中9例因激素减量过快复发；3例进行了干细胞移植的患者均获得满意疗效，已停用激素。结论 天疱疮病情的严重程度是决定激素用量的关键。激素联合免疫抑制剂治疗天疱疮疗效更佳。对激素和免疫抑制剂治疗效果不理想者可选择自体外周血造血干细胞移植，后者可能是治愈天疱疮的一种有效方法，有待进一步探索。

Analysis of treatment and observation of prognosis of pemphigus in 84 cases

Abstract] 　Objective: To summarize the treatment plan of pemphigus patients， and to analyze its therapeutic efficacy and prognosis. Methods: To retrospectively analyze clinical data of pemphigus patients in 84cases, all medicines were glucocorticoid, and immunodepressant medicine were used by 45 cases of the total, and 3 patients of 45cases chose autologous peripheral hematopoietic stem cell transplantation. To observe hormone dosis、therapeutic efficacy、adverse reaction and prognosis information of all patients. Results: Incipient hormone amount of severe case was more than it’s of middle case; therapeutic efficacy of hormone combined immunodepressant case was better than hormone case; 9 cases of follow-up patients were palindromia due to too much decrement; 3cases were good health by stem cellular transplantation, and now they have stopped using hormone. Conclusion: Serious degree of pemphigus is the key of hormone dosis. Therapeutic efficacy of hormone combined immunodepressant is better than hormone. Failed patients by conventional therapy can choose autologous peripheral hematopoietic stem cell transplantation that maybe a modus operandi to heal well pemphigus, but it need explore further.