摘要
目的红皮病是一种严重的全身性皮肤病,易继发低蛋白血症、感染、心血管病变,病因复杂,病死率高。文中旨在探讨红皮病的病因、合并症及并发感染情况。方法回顾性分析2009年1月至2016年8月南京军区南京总医院皮肤科收治的95例红皮病患者临床资料。观察患者的临床特征、病因及诱发因素、实验室检查、合并症及并发感染情况等。结果初发患者73例,反复发作者22例,其中基础疾病为银屑病者14例。致病原因分类:继发于其他皮肤病57例(60%)、药物过敏25例(26.32%)。诱发因素分类:上呼吸道感染6例、不规则糖皮质激素治疗38例、外用刺激性药物(中药擦洗及外用药酒)7例。主要合并症为心血管疾病38例(40%)。血浆清蛋白<35 g/L和≥35 g/L者并发感染率为65.78%、12.28%(P<0.01)。电解质紊乱者、正常者合并感染率分别为44.2%、25%(P<0.05)。结论红皮病患者主要病因为继发于原有疾病,尤以银屑病为多,心血管疾病为主要合并症,临床应注意及时纠正低血浆清蛋白及电解质紊乱,降低感染风险。
Objective Erythroderma is a very serious disease that affects nearly the entire cutaneous surface and are highly subjected to secondary hypoalbuminemia,infection,cardiovascular diseases,complex causes and high death rates. The article aimed to explore the etiology,comorbidities and complicated infection of erythroderma. Methods Retrospective analysis was conducted on clinical data of 95 cases of erythroderma in our department from January 2009 to August 2016. Observations were made on the patients＇ clinical characteristics,etiology and inducement,lab examination,complications and complicated infection. Results There were73 first-episode and 22 recurrent patients,among which 14 cases are psoriasis as the basic disease. As to etiological factors,there were57 cases secondary to other skin diseases（60%） and 25 cases by drug reactions（26%）. As to inducing factors,there were 6 cases by upper respiratory tract infection,38 cases by irrational application of glucocorticoids,and 7 cases by external stimulants（traditional Chinese medicine scrubbing and external medicinal liquor）. The main complications were 38 cases of cardiovascular diseases（40%）. The complicated infection rates of plasma albumin in patients 35 g/L and≥35 g/L were 65.78% and 12.28%（P〈0.01）. The complicated infection rates of the patients with hypoalbuminemia and electrolyte disturbance were 44.2% and 25% respectively（P〈0.05）. Conclusion The erythroderma is mainly secondary to previous skin diseases,mostly psoriasis,with cardiovascular diseases as the main comorbidities.In clinical practice,importance should be attached to monitoring decreased plasma albumin level and electrolyte disturbances in order to reduce the risk of infection.
作者
张媛媛
邓东灵
孔庆涛
寇彩霞
李锦
陈军
刘芳
桑红
ZHANG Yuan-yuan;DENG Dong-ling;KONG Qing-tao;KOU Cai-xia;LI Jin;CHEN Jun;LIU Fang;SANG Hong(Department of Dermatology,Jingling Hosptal,Nanjing University School of Medicine / Nanjing General Hospital of Nanjing Military Region,PLA,Nanjing 210002,Jiangsu,China)
出处
《医学研究生学报》
CAS
北大核心
2018年第7期730-733,共4页
Journal of Medical Postgraduates
关键词
红皮病
病因分析
感染
erythroderma
etiology
infection
