摘要
目的回顾性分析利伐沙班单用或联合叶酸/甲泼尼龙治疗青斑样血管病(LV)的临床疗效和安全性。方法回顾性收集2020年4月至2023年9月在开封市人民医院皮肤科通过利伐沙班单用或联合治疗的LV患者资料。治疗前患者均行血清叶酸及同型半胱氨酸检查。针对叶酸降低的患者同时予叶酸治疗;针对皮损泛发四肢且处于进展期或组织病理示真皮血管周围有致密炎症细胞浸润的患者同时予糖皮质激素治疗。分别于治疗前及治疗8周后就患者的临床症状(红斑、溃疡及疼痛)进行评分,并于治疗过程中记录不良反应发生情况。结果共纳入患者11例,男6例,女5例;年龄15~73(29.00±17.85)岁,病程1个月至4年[(13.36±15.87)个月]。11例患者中,利伐沙班联合甲泼尼龙和叶酸治疗3例,利伐沙班联合甲泼尼龙治疗1例,利伐沙班联合叶酸治疗5例,单用利伐沙班治疗2例;治疗前患者临床症状总积分为(5.00±2.28)分,利伐沙班单用或联合治疗8周时降至(1.18±0.75)分,差异具有统计学意义(t=6.90,P=0.001)。而且,治疗8周时5例疼痛患者的疼痛评分全部降为0。1例患者在治疗2周后出现凝血功能异常,未予特殊处理,治疗4周时恢复正常。结论利伐沙班单用或联合叶酸/甲泼尼龙治疗LV疗效明显,且具有较好的安全性。
Objective To retrospectively analyze the clinical efficacy and safety of rivaroxaban alone or in combination with folic acid/methylprednisolone in the treatment of livedoid vasculopathy(LV).Methods Clinical data were retrospectively collected from LV patients who were treated with rivaroxaban alone or in combination at the Department of Dermatology,Kaifeng People's Hospital from April 2020 to September 2023.Before treatment,all the patients underwent serum folate and homocysteine tests.Folic acid therapy was given to patients with low folate levels;glucocorticoid therapy was given to patients with generalized skin lesions in the extremities in the acute stage or with dense inflammatory cell infiltration around the dermal vessels on histopathological examination.Clinical symptoms(erythema,ulceration and pain)were scored before and after 8 weeks of treatment.Adverse reactions were recorded during the treatment.Results A total of 11 patients were collected,including 6 males and 5 females;their ages ranged from 15 to 73(29.00±17.85)years,and the disease duration ranged from 1 month to 4 years(13.36±15.87 months).Among the 11 patients,3 were treated with rivaroxaban combined with methylprednisolone and folate,1 with rivaroxaban combined with methylprednisolone,5 with rivaroxaban combined with folate,and 2 with rivaroxaban alone.The total score of clinical symptoms was 5.00±2.28 points before treatment,and significantly decreased to 1.18±0.75 points after 8 weeks of treatment with rivaroxaban alone or in combination(t=6.90,P=0.001).In addition,the pain scores of 5 patients who reported pain dropped to 0 point after 8 weeks of treatment.One patient experienced coagulation abnormalities after 2 weeks of treatment,and the coagulation parameters returned to normal without special treatment after 4 weeks.Conclusion Rivaroxaban alone or in combination with folic acid/methylprednisolone was effective for the treatment of LV with a good safety profile.
作者
陈佰超
张文文
付旭晖
顿耿
耿庆娜
王哲新
Chen Baichao;Zhang Wenwen;Fu Xuhui;Dun Geng;Geng Qingna;Wang Zhexin(Department of Dermatology,Kaifeng People′s Hospital,Kaifeng 475000,Henan,China)
出处
《中华皮肤科杂志》
CAS
CSCD
北大核心
2024年第10期939-943,共5页
Chinese Journal of Dermatology
基金
河南省医学科技攻关计划联合共建项目(LHGJ20210831)。
