三氯乙烯药疹样皮炎激素使用总剂量的影响因素

Influencing factors to glucocorticoid dose in treating dermatitis medicamentosa-like of trichloroethylene

目的分析三氯乙烯药疹样皮炎患者治疗使用糖皮质激素总剂量的影响因素。方法收集深圳市职业病防治院治愈的三氯乙烯药疹样皮炎病例49例作为研究对象,统计患者激素使用总剂量、三氯乙烯接触时间、丙氨酸转氨酶、天冬氨酸转氨酶、总黄疸指数、血清总蛋白、白蛋白、年龄、性别、治疗前最高体温、皮肤损害类型等基本信息,进行相关因素的多元逐步回归分析和方差分析。结果通过多元线性逐步回归分析表明治疗前最高体温、总胆红素和血清白蛋白是影响患者治愈所需甲级强的松龙总剂量的重要因素。治疗前最高体温、总胆红素与激素总剂量呈正相关,血清白蛋白含量与激素使用总剂量呈负相关。通过方差分析发现,皮疹类型对激素总剂量有重要影响。结论三氯乙烯药疹样皮炎是一种变态反应性疾病,糖皮质激素为目前最有效治疗药物,根据患者最高体温、总胆红素和血清白蛋白可预测患者治愈所需甲基强的松龙总剂量。

[Objective] To analyze the influencing factors to total glucocorticoid dose in treating dermatitis medicamentosa-like of trichloroethylene（DMLT）.[Methods]A total of 49 DMLT patients in Shenzhen Occupational Disease Prevention Hospitalwere chosen as research subjects.Their clinical data,such as total dose of glucocorticoid,the trichloroethylene exposure time,alanine aminotransferase,aspartate aminotransferase,total bilirubin,serum total protein,albumin,age,gender,the highest body temperature before treatment,skin damage type and other basic information were collected for stepwise multiple regression analysis of the relevant factors and analysis of variance.[Results]Multiple linear regression analysis showed the highest body temperature before treatment,total bilirubin and serum albumin were the important factors influencing total dose of Class A prednisolone required for cure.The highest body temperature before treatment,total bilirubin was positively correlated with total glucocorticoid dose,while serum albumin was negatively correlated with total glucocorticoid dose.Analysis of variance found that erythra type greatly impacted the total glucocorticoid dose.[Conclusion] DMLT as allergic disorder,glucocorticoids are currently the most effective therapeutic drugs.The total dose of Class A prednisolone can be calculated according to the temperature,total bilirubin,seralbumin,and erythra type.