50例寻常型天疱疮黏膜损害与糖皮质类固醇激素用量分析

Mucosal damage and dosage of glucorticosteroids in 50 cases of pemphigus vulgaris

目的 总结天疱疮患者的临床资料及治疗方案,探讨寻常型天疱疮黏膜损害与病情轻重程度、糖皮质类固醇激素合理应用的关系。方法 收集2013年8月—2020年10月的50例寻常型天疱疮患者的临床资料,对黏膜损害情况与病情轻重程度、糖皮质类固醇激素初始量、平均量、最大量、住院中位时间等进行回顾分析。结果 寻常型天疱疮患者黏膜损害组接受激素联合免疫抑制剂人数占比高于无黏膜损害组,差异有统计学意义(P<0.05);轻症组与重症组患者在首发和入院时出现黏膜损害,入院口腔黏膜损害差异有统计学意义(P<0.05);男女患者入院黏膜损害、入院外阴黏膜损害具有统计学意义(P<0.05);有黏膜损害与无黏膜损害患者在激素初始量、平均量、最大量和住院中位时间差异有统计学意义(P<0.05)。结论 寻常型天疱疮患者出现黏膜损害与病情轻重及糖皮质类固醇激素使用剂量呈正相关;出现黏膜损害的寻常型天疱疮患者需早期考虑联合使用糖皮质类固醇激素和免疫抑制剂阻止水疱的新发。

Objective To summarize the clinical data and treatments of 50 patients with pemphigus vulgaris,and to explore the relationship between mucosal damage,the dosage of glucocorticosteroids and the severity of the disease.Methods The clinical data on 50 inpatients with pemphigus vulgaris treated between August 2013 and October 2020 was collected.The incidence of mucosal damage,the severity of the disease,initial,average and maximum doses of glucocorticosteroids(mg/d)and the median length of hospitalization(d)were analyzed retrospectively.Results There was statistically significant difference between patients with mild pemphigus vulgaris and severe cases at the outset and upon admission(P<0.05).There was statistically significant difference in the initial,average,and maximum amounts of glucocorticosteroids used among these patients and in the median length of hospital stay between patients with mucosal damage and those without(P<0.05).Patients in the mucosal damage group received more hormone combined with immunosuppressants than those in the non-mucosal damage group(P<0.05).The difference in mucosal involvement and vulvar involvement between male and female patients at the outset and upon admission was statistically significant(P<0.05).Conclusion Mucosal damage in patients with pemphigus vulgaris is positively correlated with the severity of the disease and the dosage of glucocorticosteroids.For patients with pemphigus vulgaris who develop mucosal lesions,early use of glucocorticosteroids and immunosuppressants is recommended in order to prevent the development of new blisters.