159例泛发性脓疱型银屑病住院病人的回顾性分析

发布时间：2018-04-24 22:41

  本文选题：泛发性脓疱型银屑病 + 回顾性临床分析　； 参考：《宁夏医科大学》2017年硕士论文

【摘要】：目的初步探讨泛发性脓疱型银屑病的流行病学特点、临床特征、实验室检查结果、治疗方案,为临床更好地预防和治疗该病提供参考意见。方法收集整理2005年1月1日至2015年12月31日宁夏医科大学总医院、宁夏回族自治区人民医院住院治疗的所有泛发性脓疱型银屑病患者的病案资料,共159例,对所有患者的病历资料进行回顾性分析。探讨泛发性脓疱型银屑病的流行病学特点,临床特征,分析实验室检查结果,比较不同治疗方案,提出如何更好地预防和治疗泛发性脓疱型银屑病。结果159例泛发性脓疱型银屑病患者中,有17例患者为反复住院(2~7次),故实际患者128人,其中男性多于女性,男女比例为1:0.86。最小发病年龄6个月,最大发病年龄78岁,平均发病年龄为37.5±18.8岁,未成年人21人,成年人107人。首次发病时有102人既往有寻常型银屑病病史(79.7%)。128人中23人有寻常型银屑病家族史。159例患者中,有明确发病诱因者101例(63.5%),其中糖皮质激素不当使用诱发31例,上呼吸道感染诱发23例,中草药诱发18例。入院时体温37.2℃有68例(42.8%),治疗后退热时间1~46天,平均3.4±6.1天。入院后病情评估轻度有35人(22%),中度107人(67.3%),重度17人(10.7%)。实验室检查中,有76例患者白细胞升高;12例患者ALT升高,7例患者AST升高;101例有低蛋白血症;65例患者血钙降低。23例行脓疱细菌培养的患者中有14例阳性,分别为表皮葡萄球菌、金黄色葡萄球菌、人葡萄球菌、草绿色链球菌、枯草芽孢杆菌、棒杆菌。46例行血培养的患者中有6例阳性,分别为凝固酶阴性葡萄球菌、金黄色葡萄球菌、表皮葡萄球菌、缓慢葡萄球菌。治疗方案为复方甘草酸苷制剂、维A酸类药物、糖皮质激素、甲氨蝶呤、雷公藤等单独或联合应用,经治疗后,平均脓疱消退时间为10.2±7.5天,平均住院日为18天。结论1.近11年来我区泛发性脓疱型银屑病住院患者人数呈上升趋势,其中男性多于女性。2.常见发病诱因多为糖皮质激素、中草药的不当使用及上呼吸道感染。3.实验室检查大多数患者白细胞和中性粒细胞升高,血钙降低,血清白蛋白降低。4.治疗方法应多样化、个体化,维甲酸类药物、甲氨蝶呤等联合复方甘草酸苷制剂可降低药物副作用,提高疗效。
[Abstract]:Objective to explore the epidemiological characteristics, clinical features, laboratory results and treatment plan of generalized pustular psoriasis (Psoriasis) so as to provide reference for clinical prevention and treatment of Psoriasis. Methods A total of 159 cases of generalized pustular psoriasis were collected and sorted from January 1, 2005 to December 31, 2015 in the General Hospital of Ningxia Medical University and the people's Hospital of Ningxia Hui Autonomous region. The medical records of all patients were analyzed retrospectively. To investigate the epidemiological and clinical characteristics of generalized pustular psoriasis, to analyze the results of laboratory examination, to compare different treatment schemes, and to propose how to better prevent and treat generalized pustular psoriasis. Results among 159 patients with generalized pustular psoriasis, 17 patients were hospitalized twice and 7 times, so 128 patients were in fact, male was more than female, the ratio of male to female was 1: 0.86. The minimum onset age was 6 months, the maximum onset age was 78 years old, the average onset age was 37.5 卤18.8 years, 21 minors and 107 adults. At the first onset, 102 patients had a history of psoriasis vulgaris (79.7%), among them 23 cases had a family history of psoriasis vulgaris (159 cases), 101 cases had definite inducement, among which 31 cases were induced by improper use of glucocorticoid. 23 cases were induced by upper respiratory tract infection and 18 cases by Chinese herbal medicine. 68 patients with body temperature 37.2 鈩，

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