中毒性表皮坏死松解症26例临床分析

Clinical analysis of 26 patients with toxic epidermal necrolysis

目的探讨中毒性表皮坏死松解症(TEN)的临床特征、致敏药物、治疗方法及预后。方法回顾性分析26例TEN患者的临床资料。结果患者平均年龄(44.46±21.87)岁,均伴有黏膜损害,致敏药物以抗生素类、抗癫痫药、解热镇痛药、别嘌呤醇为主,26例均使用大剂量糖皮质激素,7例联合丙种球蛋白治疗。治愈21例,好转3例,死亡2例。结论 TEN是一种累及全身皮肤黏膜严重威胁生命的疾病,病死率高,早期足量使用大剂量激素联合丙种球蛋白治疗为主要的治疗手段,伴有内脏损害和严重感染的患者预后较差。

Objective To explore the clinical features,causative drugs,treatment and prognosis of toxic epidermal necrolysis（TEN）.Methods To retrospectively analyze the clinical data of 26 cases with TEN.Results The mean age of patients with TEN was（44.46±21.87） years.Mucous membranes were affected in all cases.Frequent drug-induced causes included antibiotics,antiepileptic drugs,nonsteroidal anti-inflammatory drugs（NSAIDs） and allopurinol in our data.ALL patients were given cocorticoid therapy,7 cases were treated in combination with intravenous immunoglobulin（IVIG）.The skin lesions healed in 22 cases and improved in 3 cases,2 deaths occurred.Conclusion TEN is a life-threatening exfoliating disease of the skin and mucous membranes which has a high death rate.The use of adequate dose of cocorticoids in the early phase in combination with IVIG is the major treatment of TEN,but visceral lesion and severe infection lead to a bad prognosis.