摘要
目的:探讨糖皮质激素联合静脉注射免疫球蛋白(IVIG)治疗中毒性表皮坏死松解症(TEN)的临床疗效、不良反应和转归。方法:回顾性分析15例TEN患者采用糖皮质激素联合免疫球蛋白治疗的临床资料。结果:15例TEN患者均伴有黏膜糜烂,皮损(表皮已剥脱或即将剥脱)面积占体表面积的(19.40±6.51)％;糖皮质激素用量(以泼尼松为标准量):(1.5～2.0)mg/(kg·d);IVIG用量:(0.2～0.4)g/(kg·d),连续用药(6.0±1.3)d。联合用药第(3.0±1.3)天开始起效,痊愈9例,共治疗(23.60±5.49)d;基本痊愈5例,共治疗(16.70±3.14)d;死亡1例。所有患者均可耐受IVIG治疗。结论:糖皮质激素联合IVIG治疗TEN具有协同作用,可明显提高疗效和减少死亡,减少糖皮质激素引起的不良反应。
Objectives: To investigate the effectiveness, side effects and prognosis in the combination treatment of corticosteroid and immunoglobulin in patients with toxic epidermal necrolysis(TEN). Methods: The retrospective analysis for 15 patients with TEN treated with combination of corticosteroid and immunoglobulin. Results: All patients with TEN had epidermal detachment (including mucosa of mouth and lid) which involved (19.40±6.51)% of the tatol body surface on the admission. The dosege of IVIG and corticosteroid (prednisone) was (0.2-0.4)g/(kg·d)and 1.5-2.0 mg/(kg-d) respectively, which was consecutive for (6.0±1.3)d. Patients began to respond to the therapy at (3.0±1.3)d after the treatment according to the protocol of the combination of corticosteroid and immunoglobulin. Nine patients were cured, five nearly cured and one dead . All of patients could tolerate the corticosteroid therapy combined with immunoglobulin. Conclusions: It is suggested that the corticosteroid combined with immunoglobulin has synergistic action in the treatment of patient with TEN, which obviously enhances clinical effectiveness, and decreases the side effect of corticosteroid. It is worth while recommending.
出处
《临床皮肤科杂志》
CAS
CSCD
北大核心
2004年第9期571-573,共3页
Journal of Clinical Dermatology
