28例中老年天疱疮和类天疱疮死因及相关因素分析

目的探讨中老年自身免疫性天疱疮和类天疱疮患者的死因，提高其生存率。方法结合11年来271例天疱疮和类天疱疮住院患者的临床和实验室资料，分析其中28例天疱疮、类天疱疮的死因及相关因素，并与相应的大疱病生存者作对照及统计学处理。结果天疱疮病死率10.4%，类天疱疮病死率10.1%，病死率随年龄递增。生存期分别17个月和4个月。直接死因为脏器衰竭、消化道出血、感染性休克。间接死因为继发感染、老年病和其他并、伴发症。相关因素主要是高龄、黏膜累及、激素剂量、皮损严重度。结论天疱疮患者中脏器衰竭者病死率高。类天疱疮中有黏膜损害、消化道出血者预后较差。继发感染为天疱疮、类天疱疮共同的间接死因。

Analysis Cause of Death and Related Factors in Aged and Old 28 Patients with Pemphigus and Pemphigoid

Purpose To investigate the cause of death in aged and old severe patients with autoimmune pemphigus and pemphigoid and to improve the survival rate. Methods Studying clinical and laboratory data of 271 inpatients with pemphigus and pemphigoid in our department in recent 11 years.To analyze the cause of deathe and related factors of 28 dead patients among them,and compare the dead patients with the corresponding survivers and evaluate satistically. Results The mortality rate of pemphigus was 10.4%,while,that of pemphigoid was 10.1%.The mortality rate was increased with the age.The survival period was 17 months and 4 months respectively.The direct causes of death was as follows,viscera failure,gastric bleeding,infectious shock.The indirect causes of death were secondary infection,geratologic disease and side effect of steroid.The possibility were related to aged,mucous involved,dosage of steroid and severity of lesions. Conclusions The mortality rate was high in the patients with pemphigus who suffered from viscera failure.The patients with pemphigoid who suffered from gastric bleeding and mucous involved,their prognosis was poor.Secondary infection was common indirect cause of death of pemphigus and pemphigoid.