Zhang Feng, Zhou Jin
a Department of Dermatology , The First Affiliated Hospital of Harbin Medical University , Harbin , PR China and.
b Department of Hematology , The First Affiliated Hospital of Harbin Medical University , Harbin , PR China.
Cutan Ocul Toxicol. 2017 Mar;36(1):19-24. doi: 10.3109/15569527.2016.1141416. Epub 2016 Apr 14.
The study aimed to investigate the efficacy of our therapeutic options on toxic epidermal necrolysis (TEN) patients.
After giving informed consent, patients affected by TEN were included in the study between January 2001 and December 2013. Suspected causative drugs, onset to hospitalization, complications, management, outcome, laboratory investigations of blood tests and therapeutic options were recorded and analyzed. SCORTEN scoring system was used to evaluate the complications and the survival rate. Therapeutic interventions included immediate withdrawal of any potentially fatal drug, nursing care, supportive therapy, high-dose corticosteroids, antibiotics, plasma therapy, intravenous immunoglobulins (IVIG) and traditional Chinese medicine (TCM). Blood tests were taken as a result of clinical outcome.
Total 21 consecutive patients (10 males and 11 females, mean age 33 years) were included in the study. Cefalexin, paracetamol, quick cold capsules, compound aminopyrine phenacetin tablets, carbamazepine, propylthiouracil, sulfonamide, ampicillin, and phenylbutazone were suspected to be the causative agents. All patients received high-dose dexamethasone or methylprednisolone therapy. Eighteen patients received the administration of antibiotics. Twelve patients received plasma infusions, and 11 patients were given albumin. Only 2 patients applied IVIG. Additionally, 3 and 14 cases were intravenously injected with QKL and Xiyanping, respectively. The average score of SCORTEN was 2.52 and the average percentage of total body surface area was 68.8%. The mortality rate in our study was 19%.
The therapeutic options in our study, including nursing care, corticosteroid, anti-inflammatory and TCM are effective for the treatment of TEN.
本研究旨在探讨我们的治疗方案对中毒性表皮坏死松解症（TEN）患者的疗效。
在获得知情同意后，2001年1月至2013年12月期间受TEN影响的患者被纳入研究。记录并分析可疑致病药物、发病至住院时间、并发症、治疗、结局、血液检查的实验室指标以及治疗方案。采用SCORTEN评分系统评估并发症和生存率。治疗干预措施包括立即停用任何潜在致命药物、护理、支持治疗、大剂量皮质类固醇、抗生素、血浆治疗、静脉注射免疫球蛋白（IVIG）和中药（TCM）。根据临床结局进行血液检查。
本研究共纳入21例连续患者（10例男性和11例女性，平均年龄33岁）。头孢氨苄、对乙酰氨基酚、速效感冒胶囊、复方氨基比林非那西丁片、卡马西平、丙硫氧嘧啶、磺胺类药物、氨苄西林和保泰松被怀疑为致病因素。所有患者均接受大剂量地塞米松或甲泼尼龙治疗。18例患者接受了抗生素治疗。12例患者接受了血浆输注，11例患者给予了白蛋白。仅2例患者应用了IVIG。此外，分别有3例和14例患者静脉注射了清开灵和喜炎平。SCORTEN平均评分为2.52，平均体表面积百分比为68.8%。本研究中的死亡率为19%。
我们研究中的治疗方案，包括护理、皮质类固醇、抗炎药和中药，对TEN的治疗有效。
