糖皮质激素治疗进展期白癜风疗效分析

Assessment of the efficacy and side effects of systemic corticosteroid in the treatment of patients with progressive vitiligo

目的:评价糖皮质激素治疗进展期白癜风的疗效及不良反应。方法:甲泼尼龙组进展期白癜风185例(VIDA评分4分,皮损面积>1%),予甲泼尼龙片0.48 mg/kg·d口服3日,后0.24 mg/kg·d口服27日,第2个月减为0.12 mg/kg·d,第3个月减为0.12 mg/kg·d;复方倍他米松注射液组107例(VIDA评分3分或4分,皮损面积<1%),成人予复方倍他米松注射液1.0 m L,儿童予0.015 m L/kg肌肉注射,1次/月,连用3次。结果:治疗3个月后,甲泼尼龙组和复方倍他米松注射液组有效率分别为93.0%和82.3%(P<0.05)。甲泼尼龙组不良反应发生率为82.7%,显著高于复方倍他米松注射液组62.6%(P<0.05)。结论:系统使用甲泼尼龙治疗进展期白癜风疗效优于复方倍他米松肌肉注射,但不良反应发生率相应增高。

Objective： To assess the efficacy and side effects of corticosteroid in the treatment of patients with progressive vitiligo. Methods： One hundred and eighty-five patients with progressive vitiligo（ VIDA score of 4 and lesions area1% body surface area） were treated with methylprednisolone,0.48 mg/kg a day for 3 days,and followed by 0.24 mg/kg·d for the rest 27 days of the month. The dosage was decreased to 0.12mg/kg·d during the second month and 0.06 mg/kg·d during the third month. One hundred and seven patients（VIDA score of 3 or 4 and lesions area1% body surface area） were treated with compound betamethasone injection,1.0 m L once a month in adult and 0.015 m L/kg in children for 3 times. Results： The effective rates in the methylprednisolone group and compound betamethasone group were 93. 0% and 82. 3% respectively,with a significant difference（ P 〈0. 05）. The rates of side effects were 82. 7% and 62. 6% respectively（ P 〈0.05）. Conclusion： Compared to compound betamethasone group the regimen of methylprednisolone treatment is more effective but more side effects.