糖皮质激素单用或联合丙种球蛋白治疗SJS/TEN的临床疗效:基于SCORTEN评分的回顾性分析

doi:10.3969/j.issn.1000-8535.2016.02.015

广州医药 ›› 2016, Vol. 47 ›› Issue (2): 44-46.DOI: 10.3969/j.issn.1000-8535.2016.02.015

糖皮质激素单用或联合丙种球蛋白治疗SJS/TEN的临床疗效:基于SCORTEN评分的回顾性分析

韩永智¹, 韩芳², 赵文伟³, 司徒欣欣¹

1 广东省人民医院,广东省医学科学院皮肤科(广州 510080)
2 广州市第一人民医院病案统计科( 广州510180)
3 西安大兴医院皮肤科(西安 710016)

收稿日期:2015-12-24 出版日期:2016-03-20 发布日期:2021-11-30

Efficacy of single corticosteroid or with Intravenous immunoglobulin in the treatment of SJS/TEN: a SCORTEN-based retrospective analysis

Han Yongzhi, Situ Xinxin, Han Fang, Zhao Wenwei

Han Yongzhi, Situ Xinxin. Department of Dermatology, Guangdong General Hospital & GuangdongAcademy of Medical Sciences, Guangzhou, 510080, China
Han Fang. Department of Statistics and Medical Record, Guangzhou First People's Hospital, Guangzhou 510180, China
Zhao Wenwei. Department of Dermatology, Xi'an Daxing Hospital, Xi'an 710000, China

Received:2015-12-24 Online:2016-03-20 Published:2021-11-30

摘要/Abstract

摘要： 目的评估SCORTEN评分与我国SJS/TEN患者疾病严重程度的一致性,比较单用糖皮质激素(TCS)和糖皮质激素—丙种球蛋白冲击(TCS-IVIG)联合治疗SJS/TEN的临床效果。方法收集我院2005年6月—2015年5月住院的SJS/TEN患者,计算每例患者的SCORTEN评分,采用Hosmer-Lemeshow检验评估SCORTEN模型的预期死亡率和实际死亡率的拟合度;比较单用TCS和TCS-IVIG联合治疗的患者在疾病严重程度、住院天数、疾病控制时间和死亡率方面的差异。结果 SCORTEN模型的预期死亡率和实际死亡率之间的拟合度良好(各组P值均大于0.5);二组患者在住院天数、疾病控制时间和死亡率方面的差异没有统计学意义(P分别为0.105,0.910,0.701),但TCS-IVIG组患者的疾病严重程度显著高于TCS组(P=0.017)。结论 SCORTEN评分可以用于评估国内SJS/TEN患者的病情严重程度,并预测患者预后;与单用TCS相比,联合IVIG有助于提高重症SJS/TEN患者的救治效果。

关键词: Stevens-Johnson综合征, 中毒性表皮坏死综合征, SCORTEN, 临床疗效

Abstract: Objectivs To evaluate the performance of SCORTEN in severity of SJS/TEN in China, and to compare the efficacy of corticosteroid therapy (TCS) and intravenous immunoglobulin combined therapy (TCS-IVIG). Methods Collected retrospectively the data of the SJS/TEN patients from June 2005 to May 2015 in our hospital. Hosmer-Lemeshow statistic were used to assess SCORTEN model calibration. And the differences between TCS group and TCS-IVIG group were compared in severity-of-illness, length of hospitalization, disease control time and mortality. Results A good calibration were found in all groups (all P＞0.5). Although the severity-of-illness in the TCS-IVIG group was significantly higher than that in the TCS group (P=0.017), there was no statistical significance between the two groups in length of hospitalization, disease control time and mortality (P=0.105, 0.910, 0.701, respectively). Conclusion SCORTEN can be used to assess the severity-of-illness in Chinese patients with SJS/TEN and to predict the prognosis. Compared with single TCS, It could improve the clinical outcomes of patients with severe SJS/TEN combined with IVIG.

Key words: Steven-Johnson syndrome, Toxic Epidermal Necrolysis, Severity-of illness for TEN, Efficacy

韩永智, 韩芳, 赵文伟, 司徒欣欣. 糖皮质激素单用或联合丙种球蛋白治疗SJS/TEN的临床疗效:基于SCORTEN评分的回顾性分析[J]. 广州医药, 2016, 47(2): 44-46.

Han Yongzhi, Situ Xinxin, Han Fang, Zhao Wenwei. Efficacy of single corticosteroid or with Intravenous immunoglobulin in the treatment of SJS/TEN: a SCORTEN-based retrospective analysis[J]. Guangzhou Medical Journal, 2016, 47(2): 44-46.

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糖皮质激素单用或联合丙种球蛋白治疗SJS/TEN的临床疗效:基于SCORTEN评分的回顾性分析

Efficacy of single corticosteroid or with Intravenous immunoglobulin in the treatment of SJS/TEN: a SCORTEN-based retrospective analysis

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