115例大疱性类天疱疮患者的IgE临床分析

Clinical analysis of IgE levels in 115 cases of bullous pemphigus

目的分析115例大疱性类天疱疮(BP)患者的IgE结果与临床特点。方法收集2018年1月至2023年12月山西省太原市中心医院皮肤科住院的115例大疱性类天疱疮患者的临床资料,根据IgE结果进行分组比较,并分析其与性别、年龄、合并症及疾病严重程度的关系。结果115例BP患者起病年龄25~99岁,平均年龄(70.53±12.41)岁;81例(70.43%)在起病前即合并其他基础疾病,最常见的是原发性高血压、糖尿病、脑梗死、冠心病;其中95例患者进行了BP疾病活动指数(BPDAI)评分,不符合正态分布,中位数为24分;其中94例(81.74%)患者IgE水平升高;与IgE正常组比较,IgE升高组更易合并其他系统疾病,且BP180 IgG水平更高。2组患者BPDAI总分差异无统计学意义,但IgE升高组患者的糜烂/水疱评分更高。结论BP集中发生于老年人,多合并循环系统及神经系统疾病。由于老年BP患者早期临床表现不典型,诊断存在一定的困难,结合IgE有助于识别早期BP,以尽早干预。虽然疾病严重程度与IgE是否升高无关,但IgE升高的BP患者更应注重皮肤糜烂、水疱的预防和护理,以及考虑合并症的全方位、个体化治疗。

Objective To summarize the clinical characteristics and IgE levels in 115 case of bullous pemphigoid(BP). Methods The clinical data of 115 patients with bullous pemphigoid(BP) hospitalized in the Department of Dermatology, Taiyuan Central Hospital, from January 2018 to December 2023 were collected. The patients were grouped and compared based on their IgE levels, and the relationship between IgE levels and factors such as gender, age, comorbidities, and disease severity was analyzed. Results The age of onset of disease in 115 patients with BP ranged from 25 to 99 years, with a mean of 70.53 ± 12.41 years. 81 cases(70.43%) had comorbidities prior to the onset of BP, with the most common being primary hypertension, diabetes, cerebral infarction, and coronary heart disease. The BP disease activity index(BPDAI) score was assessed in 95 patients, which did not follow a normal distribution, with a median score of 24. Elevated IgE levels were observed in 94 patients(81.74%). Compared with the normal IgE group, the elevated IgE group was more likely to have other systemic diseases and higher BP180 IgG levels. Although there was no significant difference in the total BPDAI score between the two groups, the elevated IgE group had a higher score for erosion/bullae. Conclusion BP predominantly affects the elderly and is often associated with comorbidities of the cardiovascular and nervous systems. Due to the atypical early clinical presentation of BP in older patients, diagnosis can be challenging. The measurement of IgE levels can assist in identifying early-stage BP, allowing for prompt intervention. Although disease severity is not related to elevated IgE levels, patients with increased IgE should receive greater attention to the prevention and care of skin erosion and blisters, as well as comprehensive, individualized treatment that takes comorbidities into account.