【摘要】 目的:研究泛发性脓疱型银屑病(GPP)的诱因、常规药物的疗效和预后的影响因素。方法:回顾性分析21例住院GPP患者的临床资料及治疗过程。结果:感染及不规则使用皮质类固醇激素治疗是GPP诱发或加重的重要因素。11例院外已系统应用激素者,入院后联合应用Tigason(银屑灵)(0.9mg～1mg/kg/d)或CSA(环孢菌素A)(4mg～5mg/kg/d)具有协同的疗效,1w～2w内总有效率达90％;但随访发现3年内复发4例,其中1例继发类固醇性糖尿病合并青光眼,1例发生骨质疏松。3例GPP患者单独应用Tigason(0.7mg～1mg/kg/d),7d～14d脓疱消退,3例GPP患者单独应用CSA(3mg～4mg/kg.d),3d～7d脓疱消失。结论:皮质类固醇激素不被推荐作为常规一线治疗药物。药物对个体的疗效及副作用受年龄、病程、既往用药情况等因素的影响而有所区别。建议采用顺序疗法或联合疗法。更多还原

【Abstract】 Objective:To study the cause of GPP, the therapeutic effects of routine drugs and the prognosis of patients. Methods: Clinical data of 21 in patients with GPP were retrospectively analyzed. Results: Infection and irregular corticosteroid therapy were important factors in inducing and aggravating the desease. 11 patients who had been received systemic corticosteroid therapy before admission, then were combined with tigason(0.9 ~ 1 mg/kg/d) or CSA(4 ~ 5 mg/kg/d) .9 of them cured and 1 improved in 1 ~ 2 weeks. While the follow - up data showed that 4 patients relapsed in the following 3 years, 1 patient was diagnosed as steroid - induced diabetes and glaucoma, 1 patients combined with osteoporosis . There were other 3 cases responded well to the single medication of tigason(0.7 ~ 1 mg/kg/ d) ,with the pustula complete remission in 1 ~ 2 weeks. 3 patient’ s pustula rapidly cleared in 3 ~ 7 days when treated by CSA (3-4 mg/kg/d) monotherapy. Conclusion: Corticosteroids are not recommended as the first - line therapy. The response and side effect of the therapy related to the age, ill course,underlying disease and previous therapy. It was suggested that sequential form of therapy or combination therapy would improve the prognosis of the disease.更多还原