CAJ | 학술논문

目的探讨天疱疮和类天疱疮诊断与治疗特点.方法对2003-2007年天疱疮和类天疱疮648例患者的临床资料进行同顾性分析.结果天疱疮平均发病年龄低于类天疱疮(P＜0.001),直接免疫荧光(DIF)确诊的175例天疱疮患者中IgG100%阳性,C3 92.0%阳性;类天疱疮223例患者中C399.1%阳性,IgG 51.12%阳性.两种大疱性疾病的诊断中,①天疱疮患者的临床诊断、病理检查与DIF三者一致率为68.8%.病理检查、DIF两者一致率为80.7%.②类天疱疮患者的临床诊断、病珲检查与DIF三者一致率为62.8%.病理检查、DIF两者一致率为78.1%.糖皮质激素是治疗两种疾病的主要手段,泼尼松(0.5～1.5)mg·kg-1·d-1可控制大部分患者病情.结论临床和病理无法确诊的大疱疮和类天疱疮病例,DIF可以作为诊断该病的重要方法.在基层医院,临床怀疑天疱疮,DIF可主要检查IgG、C3,怀疑类天疱疮,可主要检查C3.
목적 탐토천포창화류천포창진단여치료특점.방법 대2003-2007년천포창화류천포창648례환자적림상자료진행동고성분석.결과 천포창평균발병년령저우류천포창(P＜0.001),직접면역형광(DIF)학진적175례천포창환자중IgG100%양성,C3 92.0%양성;류천포창223례환자중C399.1%양성,IgG 51.12%양성.량충대포성질병적진단중,①천포창환자적림상진단、병리검사여DIF삼자일치솔위68.8%.병리검사、DIF량자일치솔위80.7%.②류천포창환자적림상진단、병혼검사여DIF삼자일치솔위62.8%.병리검사、DIF량자일치솔위78.1%.당피질격소시치료량충질병적주요수단,발니송(0.5～1.5)mg·kg-1·d-1가공제대부분환자병정.결론 림상화병리무법학진적대포창화류천포창병례,DIF가이작위진단해병적중요방법.재기층의원,림상부의천포창,DIF가주요검사IgG、C3,부의류천포창,가주요검사C3.
Objective To analyze the diagnosis and therapy of pemphigus and pemphigoid.Methods Clinical data were retrospectively analysed for 648 patients with pemphigus or pemphigoid admitted in Huashan Hospital,Fudan University from 2003 to 2007.Results The mean age of onset of pemphigus was younger than that of pemphigoid(47.0±16.9 years vs 65.1±13.9 years.P＜0.001).Of 175 patients with pemphigus confirmed by direct immunoflorescence(DIF),100%were positive for IgG,and 92.0%for C3,while out of 223 patients with pemphigoid,51.12%were positive for IgG,99.1%for C3.For pemphigus,the consistency reached 68.8%among clinical diagnosis.pathological diagnosis and immunological(DIF)diagnosis,80.7%between pathological and immunological diagnosis.In the case of pemphigoid,the consistency was 62.8%among clinical,pathological and immunological diagnosis,and 78.1%between pathological and immunological diagnosis.Corticosteroids were primary treatment strategy for both pemphigus and pemphigoid.and prednisone of 0.5-1.5 mg per kilogram bodyweight per day could control the condition of most patients.Conclusions DIF could be used as an important diagnostic means for patients with pemphigus or pemphigoid which can not be confirmed by clinical manifestation or pathology.In primary hospitals,IgG and C3 are recommended for DIF testing when pemphigus is suspected,and C3 is recommended for suspected pemphigoid.