摘要
目的总结20年间治疗124例大疱性类天疱疮的经验。方法1985年3月至2005年4月在我院确诊为大疱性类天疱疮的患者124例，按体表受累面积分为轻症组33例、中症组46例、重症组45例。分别给予泼尼松初始剂量20～30mg／d，40mg／d和60mg／d，其后1周内病情控制不理想者剂量增加50％，对于超过100mg/d仍不能控制者予以静脉滴注甲泼尼龙250或500mg／d连续3天治疗。同时，对于大多数中、重症患者在开始治疗8周内即联合应用一种免疫抑制剂，病情控制后进入维持治疗期后逐渐减少糖皮质激素用量，并密切监测不良反应。结果91例患者已治愈或基本治愈，12例在随访期内死亡，17例仍在维持治疗，4例失访。结论总结出临床上治疗大疱性类天疱疮可供参考的经验。
Objective To summarize our experience of treating 124 patients with bullous pemphigoid （ BP ） and propose a treatment algorithm based on the affected body surface area （ BSA ）. Methotis A retrospective study was performed of 124 patients with a diagnosis of bullous pemphigoid admitted to Beijing University First Hospital over a period of 20 years. The initial dose of prednisone was 20 - 30 mg/d, 40 mg/d, or 60 mg/d, based on baseline affected BSA of less than 10%, 10 - 50%, or greater than 50%, respectively. If adequate response was not achieved within one week, the dose was increased by 50% up to 100 mg/L. Pulsed intravenous methylprednisolone 250 or 500 mg/d for 3 days was given to refractory cases. Meanwhile, a concomitant immunosuppressant was given to most moderate-to-severe cases within the first 8 weeks of treatment or to control the mild recurrence during maintenance therapy. Such induction therapy continued until resolution of skin lesions, followed by gradual tapering of dose to discontinue therapy in several months to years. Results Of these patients, 91 experienced an outcome of ＂clinical cure＂ or ＂almost cure＂, 12 died during the follow-up period, 4 lost to follow-up, the other 17 were still on maintenance therapy. Conclusion The algorithm of combination therapy with corticosteroids and other immunosuppressants based on the affected BSA was proved to be effective and practical to treat BP.
出处
《中华皮肤科杂志》
CAS
CSCD
北大核心
2007年第1期7-9,共3页
Chinese Journal of Dermatology
