Clinical Analysis of 102 cases of Pemphigus with infection
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摘要: 目的 探讨天疱疮患者的转归及感染情况,并分析诱发感染的相关因素,为临床治疗提供指导。 方法 对杭州市第三人民医院收治的102例天疱疮患者临床资料进行回顾性分析,所有患者均根据病情轻重程度不同选取个体化治疗方案,以糖皮质激素治疗为主,并积极给予其他相关治疗如保护胃黏膜、纠正电解质紊乱等。主要选用甲泼尼龙,初始激素剂量相当于泼尼松30~40 mg/d(轻症)、60~80 mg/d(中症)、80~100 mg/d(重症)。观察并记录患者的转归及感染情况,分析感染率与年龄、性别、病情严重程度的关系。 结果 治疗后,病情缓解患者93例,缓解率为91.18%;死亡患者3例,病死率为2.94%。共有37例患者出现感染,感染率为36.27%。其中皮肤感染28例,肺部感染5例,败血症4例,尿路感染5例,口腔念珠菌感染6例,多重感染8例。标本培养显示,金黄色葡萄球菌感染率最高,约占总感染人数的13.73%。患者感染率与病情程度有关,重症天疱疮感染率(48.89%)高于中症(30.00%)和轻症(17.65%),中症与轻症患者之间感染率差异无统计学意义。 结论 天疱疮合并感染临床发病率较高,且易并发重症感染。在临床工作中,要重视皮肤护理及感染的预防,尤其对于重症天疱疮患者,一旦明确感染,应及时足量使用相关敏感抗菌药物。Abstract: Objective To investigate the outcome and infection situation of patients with pemphigus,analyze the cause of infection,and provide guidance for the clinical treatment of pemphigus. Methods Total 102 cases of pemphigus in our hospital were retrospectively analyzed.According to the situation of different patients,the individualized treatment was performed,other related treatment such as protecting gastric mucosa;correcting electrolyte disorders,etc.were alsoprovided.The initial hormone doses of Methylprednisolone was equivalent to 30 to 40 mg/d(mild),60-80 mg/d(moderate) and 80-100 mg/d(severe) prednisone.The outcome of patients and infections were observed.The relationship between the prevalence and age,gender and severity of pemphigus was analyzed. Results The remission rate was 91.18%(93/102);the mortality was 2.94%(3/102).Total 37 cases got infection with an infection rate of 36.27%.Twenty-eight cases got skin infections,5 cases lung infection,4 cases sepsis,5 cases urinary tract infection,6 cases oral candida infection,8 cases multiple infections.The Bacterial culture for specimens showed that staphylococcus aureus infection rate was 13.73%.The infection rate of patients with severe pemphigus was 48.89%,which was higher than mild(17.65%). Conclusion The patients with pemphigus has a high risk of infection,also severe inflection.Preventing infection and providing positive anti-infection treatment has a role for the treatment of pemphigus.
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Key words:
- Pemphigus /
- Outcome /
- Infection /
- Methylprednisolone /
- Staphylococcus aureus
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