重症寻常型天疱疮25例的治疗和依从性分析

Treatment and Compliance of 25 Patients with Severe Pemphigus Vulgaris

目的探讨基层医院治疗重症寻常型天疱疮的难点和患者依从性等因素对疗效的影响。方法回顾分析25例重症寻常型天疱疮的临床资料。结果患者多为复发者(占84.00%),以低收入的农民和工人为主(占68.00%),入院时大多病情较重(全身皮肤受累占88.00%,口腔黏膜受损占76.00%,≥2种合并症占44.00%)。激素早期联合免疫抑制剂治疗取得满意疗效,总有效率为88.00%。激素导致的不良反应有76.32%发生在长时间大剂量持续应用激素的患者。结论重症天疱疮的治疗方案应个体化,以尽早控制病情,避免由于长时间大剂量持续应用激素而引发严重副作用。同时,应提高患者用药的依从性和基层医生对重症寻常型天疱疮的诊疗水平,有效降低复发率。

Objective To evaluate the treatment, compliance and other influencing factors to patients with severe pemphigus vulgaris from primary hospital. Methods The clinical data of 25 patients with severe pemphigus vulgaris were retrospective analyzed. Results Among of all patients, 84.00% relapsed, 68.00% were low-in- come farmers and workers. Many patients were very severe, total skin involved was 88.00% , oral mucosa involved 76.00% , more than 2 complications was 44.00%. Early use of hormone and immunosuppressant received a good result, the efficient was 88.00%. The patients who take prolonged high-dose of hormone may get the adverse reactions of hormone, the morbidity was 76.32%. Conclusion The treatment plan of severe pemphigus vulgaris should be personalized. Control the disease as early as possible, avoid prolonged high-dose use of hormone and its severe complications. It is necessary to increase the patient＇compliance and technique of doctors, decrease the recurrence rate.