ABSIS评分在寻常型天疱疮患者中的应用

Autoimmune Bullous Skin Disorder Intensity Score(ABSIS) in the treatment of patients with pemphigus vulgaris

目的 探讨自身免疫性大疱性皮肤病严重程度评分(ABSIS评分)在寻常型天疱疮治疗中的应用价值。方法 对本科的16例寻常型天疱疮入院时、激素减量时及出院时应用ABSIS评分法进行皮肤及黏膜严重程度评分,并同时记录患者的抗天疱疮抗体滴度。结果 入院时、糖皮质激素减量时及出院时ABSIS皮肤评分中位数分别为55,36及15.5,平均52.8,34.3和15.4,ABSIS黏膜评分中位数分别为3/16,2/8.5及0/0,平均3.3/15.8,2.1/8.3和0.6/1.1。抗天疱疮抗体滴度中位数分别为1:160,1:80及1:40,平均1:387.5,1:141.3及1:55。结论 ABSIS评分可从患者的皮损面积及质量、受累口腔黏膜数量及质量方面全面评价天疱疮患者的病情,比监测抗天疱疮抗体滴度能更灵敏的反应病情变化情况,可用于指导寻常型天疱疮患者的治疗及护理。

Objective To investigate the usefulness of Autoimmune BuUous Skin Disorder Intensity Score （ABSIS） in the treatment of patients with pemphigus vulgaris in China. Methods Sixteen patients who were diagnosed as pemphigus vulgaris were evaluated by ABSIS when admitted, reduction of steroid and discharged. Record serum autoantibody titres tested by indirect immunofluoreseence. Results The median ABSIS values for skin in the patients with pemphigus vulgaris when they were admitted, reduction of steroid and discharged were 55. 36, 15.5, and the average value were 52.8, 34.3, 15.4, respectively. The median ABSIS score for mucosal lesions were 3/16, 2/8.5,0/0, and the average value were 3.3/15.8, 2.1/8.3, 0.6/1.1, re- spectively. The median serum autoantibody titres were 1 ： 160, 1 ： 80, 1 ： 40, and the average value were 1 ： 387.5, 1 ： 141.3, 1 ： 55, respectively. Conclusion ABSIS consists of a quality and quantity based score for cutaneous lesions and oral mucosal involvement can monitor the status of patients with pemphigus. ABSIS score can truly reflected clinical disease activity while autoantibody titers did not. So ABSIS score can be used as a guidance in the treatment and nursing care of patients with pemphigus vulgaris.