108例天疱疮患者的生存分析

Survival analysis of 108 pemphigus patients

目的调查新疆地区天疱疮患者的5年生存情况,以及影响天疱疮预后的多种综合因素。为天疱疮的临床诊疗和预后评估提供参考。方法收集108例天疱疮患者的临床资料,并通过电话咨询进行5年的随访。生存单因素分析采用Kaplan-Meier法,并进行Log-rank时序检验;多因素分析采用Cox逐步回归模型。结果天疱疮患者的5年生存率为9.26%,在死亡的患者中,患者分别在8、11、12、12、15、24、27、34、34、35月死亡。Kaplan-Meier生存分析提示年龄、疾病分型、疾病严重程度、皮质类固醇初始剂量以及CRP值与预后相关。多因素分析显示,其中年龄≥50岁、皮质类固醇初始剂量≥1mg/kg以及CRP≥8 mg/L是天疱疮生存的独立危险因素。结论年龄≥50岁、皮质类固醇初始剂量≥1 mg/kg/天以及CRP≥8 mg/L是天疱疮生存的独立危险因素,对该类天疱疮患者要做到尽早干预治疗,密切随访,以降低死亡率。

Objective To investigate the 5-year survival status of patients with pemphigus in Xinjiang and various comprehensive factors affecting the prognosis of pemphigus.In order to provide reference for clinical diagnosis and treatment and prognosis evaluation of pemphigus.Methods The clinical data of 108 pemphigus patients were collected and followed up for 5 years through telephone consultation.The Kaplan-Meier method was used for survival univariate analysis,and Log-rank test was performed;the Cox stepwise regression model was used for multivariate analysis.Results The 5-year survival rate of pemphigus patients was 9.26%.Among the patients who died,the patients died at 8,11,12,12,15,24,27,34,34,and 35 months.Kaplan-Meier survival analysis suggested that advanced age,whether to use cyclophosphamide,whether to use albumin,the initial dose of corticosteroids,and CRP value are related to the prognosis.Multivariate analysis showed that advanced age and CRP≥8 mg/L were independent risk factors for pemphigus survival.Conclusion Old age and CRP≥8 mg/L are independent risk factors for pemphigus survival.Patients with pemphigus should be treated with early intervention and follow-up closely to reduce mortality.