儿童渗出性多形性红斑41例临床分析

The Clinical analysis of 41 Children with Erythoma Exudativum Multiforme

目的探讨儿童渗出性多形性红斑的临床特点。方法回顾性分析2007年1月至2010年6月在我院住院治疗的渗出性多形性红斑41例。针对诱因、皮疹特点、发热时间、粘膜和脏器损伤、实验室检查、治疗干预时间等进行临床分析。结果所有病例均有皮疹，78％累及口腔粘膜，44％有脏器功能损害。18例行了流式细胞相对计数检查，其中病程≤14天5例，B淋巴细胞相对计数为23％～32％（中位数26％），病程〉14天13例，B淋巴细胞相对计数为25％～52％（中位数34％），P=0．026。29例使用常规量激素，其中9例，激素干预开始时间在发病后7天以内，其病程为7～26天（中位数17天）；20例激素干预开始时间在发病后7天之后，其病程为9—35天（中位数22天），P=0．019。结论早期诊断和足量使用激素进行干预是治疗的关键，特别是针对存在明显免疫紊乱和高敏性损伤的病例，早期干预能明显的改善预后。

Objective To Investigate the clinical features of children with Erythoma Exudativum Multiforme. Methods A retrospective analysis were performed in 41 cases of Erythoma Exudativum Muhifonne from January 2007 to June 2010 in our hospital to reveal clinical characteristics of incentives, rash , fever, mucous membrane and organ damage, laboratory tests, therapeutic intervention time.Besults All patients had rash, 78% involved the oral mucosa, 44% had organ dysfunction. 18 patients accepted relative count check of flow cytometry. Among them, disease duration is 14 days or less in 5 cases, whose B lymphocytes relative count is 23% to 32% （ median 26% ）;, disease duration is greater than 14 days in 13 cases, whose B lymphoid cell count is 25% to 52% （ median 34% ）, P= 0.026. 29 cases used conventional amount of hormones, of which 9 cases were performed hormone intervention in the start time within 7 days after onset of illness, whose duration is 7 - 26 days （ median 17 days ） 20 cases of hormone intervention after the start time 7 days after onset, whose duration is 9 to 35 days （ median 22 days ）, P= 0.019. Conclusion Early diagnosis and enough hormone intervention are the key to treatment, particularly for some cases of immune disorders and the apparent high sensitivity of injury. Early intervention can significantly improve the prognosis.