重症大疱性类天疱疮患者血清抗体变化规律与病情相关性的研究

Correlation of serum BP180NC16a-ELISA index with the process of severe bullous pemphigoid

目的：研究重症大疱性类天疱疮（ bullous pemphigoid ， BP ）患者血清中抗体BP180NC16a的酶联免疫吸附试验（ELISA）指数变化情况，观察其与病情变化的相关性，并分析用于病情监测和指导治疗的临床意义。方法对12例皮损面积＞50％的重症大疱性类天疱疮患者血清抗体BP180 NC16 a水平在不同时期进行监测及评分，并分析之间的关系。结果12例患者，平均年龄65岁，皮损面积均大于全身体表面积的50％以上。皮疹主要表现为疱壁紧张的大疱、水疱，部分有口腔黏膜损害。患者皮损面积和病情评分与血清抗体BP180NC16a-ELISA指数具有显著性关联（P＜0．05），患者疾病活动期和临床缓解期抗体BP180NC16a-ELISA指数几乎与病情呈平行变化，并且该指数可以预测病情，从而指导治疗。结论重症大疱性类天疱疮多为老年患者，病情危重，在发病早期不易诊断，因而延误治疗导致死亡。血清中抗体BP180 NC16 a-ELISA 指数可反映疾病的活动程度，用于病情监测，为治疗时根据个体差异选用适量的糖皮质激素快速控制病情提供了有利的实验室证据。

Objective To investigate BP180NC16a -enzyme linked immunosorbent assay （ELISA） index changes in patients with severe bullous pemphigoid （BP） and to analyze its clinical significance for disease monitoring and therapeutic guidance .Methods Serum BP180NC16 -ELISA index were monitored in 12 cases of severe BP whose lesion area was greater than 50%, and its correlation to the process of severe BP was analyzed .Results Twelve patients , average aged 65 years old, whose lesion area to the whole body surface area was more than 50%.Rash was mainly for blister wall tension bullae, blisters, part of oral mucosal lesions .The psoriasis area and severity scores in patients were significantly correlated to BP180NC16-ELISA index （P＆lt;0.05）.BP180NC16-ELISA index acted paralleled with disease process during active phase and clinical remission phase .And the ELISA index can predict disease , so as to guide therapy .Conclusion BP for elderly patients , are often accompanied by large areas of their skin infection , ion disorder , multiple organ failure and other diseases , in critical condition .For elder BP patients , it is not easy to diagnose during the early phase of disease, but delayed diagnosis and treatment can lead to death .Serum BP180NC16a-ELISA index can reflect the degree of disease activity; therefore can be used for monitoring the disease state .It also provides laboratory evidence for a proper clinical amount of glucocorticoid according to individual difference which aims to rapidly control of disease development .