摘要
目的:分析大疱性类天疱疮患者临床特征及预后影响因素。方法:收集2014年2月至2018年1月160例大疱性类天疱疮患者临床资料,分析其临床特征,并对患者进行随访,根据其预后情况将患者分为预后良好组与预后不良组,探讨影响预后的因素。结果:患者正常皮肤或红斑上可见张力性水疱,皮损部位主要为躯干及四肢,75例自觉瘙痒,患者皮损类型多为单纯皮肤损害,尼氏征阳性者10例。组织病理检查均显示有表皮下水疱或裂隙形成,免疫荧光检查显示多数患者基底膜有IgG+C3沉积,部分可见IgM沉积。160例患者中125例为预后良好,35例为预后不良。预后不良组年龄≥60岁、WBC≥10×10~9L-1、白蛋白<35g/L、IgG≥15.6g/L、单独使用激素治疗、合并糖尿病、合并肺部感染比例均高于预后不良组,差异具有统计学意义(P<0.05)。Logistic回归分析显示,单独使用激素治疗、合并糖尿病、合并肺部感染是患者预后不良独立危险因素。结论:大疱性类天疱疮患者临床症状较为明显,组织病理和免疫荧光检查可见特征性表现,单独使用激素治疗、合并糖尿病、合并肺部感染是影响患者预后的重要因素,临床应针对性给予干预措施。
Objective:To analyze the clinical features and prognostic factors of patients with bullous pemphigoid.Methods:The clinical data of 160 patients with bullous pemphigoid admitted to our hospital from February 2014 to January 2018 were collected and analyzed.The patients were followed up and they were divided into the good proup group and the poor prognosis group.Factors affecting the prognosis were explored.Results:Tension blisters were observed on normal skin or erythema of patients.Skine lesions were mainly located at trunk and limbs.75 patients had consciously itching.The main type of skin lesions was simple skin lesions,and 10 patients had positive Nissl's sign.Histopathological examination showed subepidermal blister or fissure formation.Immunofluorescence showed that most patients had IgG+C3 deposition in the basement membrane,and some had IgM deposition.Of the 160 patients,125 had good prognosis and 35 had poor prognosis.The proportions of patients≥60 years old,WBC≥10×109L-1,albumin<35g/L,IgG≥15.6g/L,hormone therapy alone,diabetes mellitus and pulmonary infection in the good prognosis group were higher than those in the poor prognosis group(P<0.05).Logistic regression analysis showed that hormone therapy alone,diabetes mellitus and pulmonary infection were independent risk factors for poor prognosis.Conclusion:The clinical symptoms of patients with bullous pemphigoid are obvious.The histopathological and immunofluorescence examinations show characteristic features.Hormone therapy alone,diabetes mellitus and pulmonary infection are important factors affecting the prognosis of patients.Therefore,target intervention measures should be taken.
作者
杨利蓉
YANG Lirong(West China Hospital of Sichuan University,Sichuan Chengdu 610041,China)
出处
《河北医学》
CAS
2018年第12期2076-2080,共5页
Hebei Medicine
关键词
大疱性类天疱疮
临床特征
预后
影响因素
Bullous pemphigoid
Clinical features
Prognosis
Influencing factors
