He Z, Wang B, Yu B
PUMC Hospital, CAMS and PUMC, Beijing 100730.
Zhongguo Yi Xue Ke Xue Yuan Xue Bao. 1998 Apr;20(2):144-7.
Reasonable therapeutic dosage regimen for pemphigus are analyzed to find the factors related to prognosis.
A retrospective study is made on 64 cases of pemphigus who were admitted to our hospital between 1986-1996.
Sixty-two of 64 cases with pemphigus were treated with systemic administration of corticosteroids. The average dosage of prednisone for controlling the diseases were 0.958 mg.kg-1.d-1 for mild-type of pemphigus (12 cases) and 1.145 mg.kg-1.d-1 for severe-type (50 cases) respectively. Furthermore, 26 of 62 cases were treated with corticosteroids only, and the average dosage of prednisone for controlling the diseases was 1.072 mg.kg-1.d-1 while in 36 cases treated with corticosteroids combined with immunosuppressors, the average dosage of prednisone was 1.178 mg.kg-1.d-1. The rate of side-effects and complications were 15.4% in patients with corticosteroids alone and 36.1% in patients with combined therapy. Six of eight patients who died were diagnosed pemphigus vulgaris and seven with a course of disease less than 3 years.
We recommend a moderate to high dosage of corticosteroids be the first choice to control pemphigus. Those who were effective with steroids are not recommended to use additional immunosuppressors. Patients with pemphigus vulgaris usually have a poor prognosis while those who could survived more than 4 years usually have a better outcome.
分析天疱疮合理的治疗剂量方案,以找出与预后相关的因素。
对1986年至1996年间我院收治的64例天疱疮患者进行回顾性研究。
64例天疱疮患者中,62例接受了糖皮质激素全身治疗。控制病情时,轻度天疱疮(12例)泼尼松平均剂量为0.958mg·kg⁻¹·d⁻¹,重度天疱疮(50例)为1.145mg·kg⁻¹·d⁻¹。此外,62例中26例仅用糖皮质激素治疗,控制病情时泼尼松平均剂量为1.072mg·kg⁻¹·d⁻¹,36例采用糖皮质激素联合免疫抑制剂治疗,泼尼松平均剂量为1.178mg·kg⁻¹·d⁻¹。单用糖皮质激素患者的副作用和并发症发生率为15.4%,联合治疗患者为36.1%。死亡的8例患者中,6例诊断为寻常型天疱疮,7例病程小于3年。
我们建议中高剂量糖皮质激素作为控制天疱疮的首选。对激素有效的患者不建议加用免疫抑制剂。寻常型天疱疮患者预后通常较差,而存活超过4年的患者通常预后较好。