甲损害对泛发性脓疱型银屑病病情评估的指导意义
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甲损害对泛发性脓疱型银屑病病情评估的指导意义
发表时间:2017-11-20T14:04:03.733Z 来源:《航空军医》2017年第19期作者:雷泽宝
[导读] 甲损害对泛发性脓疱型银屑病病情评估具有重要的指导意义,患有甲损害预示患者可能病情较为严重。
(江华瑶族自治县人民医院湖南江华 425500)
摘要:目的探讨甲损害对泛发性脓疱型银屑病病情评估的指导意义。方法选取2013年3月 ~ 2016年3月期间来我院接受治疗的泛发性脓疱型银屑病患者108例,分为对照组与观察组。其中对照组75例,不伴有甲损害;观察组33例,伴有甲损害。观察并对比分析两组患者的资料情况、治疗前后各项指标变化、治疗结果等。结果观察组的男性比例、平均年龄、平均体重等均明显高于对照组,且差异具有统计学意义,即P < 0.05。然而,观察组与对照组的家族病史、发病诱因、季节性发病等均无显著性差别,即P >0.05。对照组的发热、白细胞升高、高血脂比例在治疗前、后有明显变化,观察组亦然,结果均具有统计学差异,即P < 0.05;观察组的三项指标与对照组相比,在治疗前、后均无显著性差异,即P >0.05。对照组的住院时间、无新发脓包时间及体温恢复正常时间均短于观察组,且差异均具有统计学意义,即P < 0.05。结论甲损害对泛发性脓疱型银屑病病情评估具有重要的指导意义,患有甲损害预示患者可能病情较为严重,需接受及时、有效、针对性的治疗。
关键词:甲损害;泛发性脓疱型银屑病;病情评估;临床意义
Guiding significance of a lesion on generalized pustular psoriasis
Abstract Objective:To investigate the significance of nail damage in the evaluation of generalized pustular psoriasis. Methods:108 patients with generalized pustular psoriasis treated in our hospital from March 2013 to March 2016 were divided into two groups:control group and observation group. Among them,75 cases in the control group were not associated with nail damage,and 33 cases in the observation group were accompanied by nail damage. Observation and comparative analysis of the two groups of patients data,changes in the index before and after treatment,treatment results. Results:the male proportion,average age and average weight of the observation group were obviously higher than that of the control group,and the difference was statistically significant,that is,P < 0.05. However,there was no significant difference between the observation group and the control group in terms of family history,predisposing factors and seasonal onset,that is,P > 0.05. The control group of fever,leukocytosis,high blood lipid ratio changes obviously before and after the treatment,the observation group,vice versa,the results were statistically significant,P < 0.05;three indexes of the observation group compared with the control group,there were no significant differences between before and after treatment,P,0.05. The control group hospitalization time,no new cases of impetigo time and the temperature recovery time was shorter in the observation group,and the differences were statistically significant,P < 0.05. Conclusion:there is an important guiding significance for the assessment of the severity of generalized pustular psoriasis. A patient with a lesion of the nail indicates that the patient may be seriously ill and should receive timely,effective and targeted treatment.
Keywords nail damage;generalized pustular psoriasis;disease evaluation;clinical significance;
泛发性脓疱型银屑病是银屑病中一种较为特殊、少见的类型。该病具有一定的死亡率,其临床症状常表现为泛发全身的脓包、发热、乏力等,且常伴随红皮病、甲损害等[1]。为探讨甲损害对该病的指导意义,本研究选取我院治疗的泛发性脓疱型银屑病患者108例进行回顾性分析。现报道如下。
1 资料与方法
1.1 研究对象
选取2013年3月 ~ 2016年3月期间来我院接受治疗的泛发性脓疱型银屑病患者108例进行回顾性分析。所有患者分为对照组与观察组。其中对照组75例,不伴有甲损害;观察组33例,伴有甲损害。所有患者中男性66例,女性42例;年龄范围26 ~ 73岁,平均年龄(41.56±13.68)岁;体重为39~ 93 kg,平均体重(62.74±12.13)kg;病程7 d ~ 46 年,平均病程(15.82±5.17)年;有家族病史13例(12.04%),无家族病史95例(87.96%);季节性发病47例(43.52),无季节性发病61例(56.48%);诱因发病55例(50.93%),无诱因发病53例(49.07%)。患者入选标准:确诊为泛发性脓疱型银屑病患者;患者及其家属知情且同意;非妊娠期、哺乳期患者;无糖尿病、精神病、心、肺、肾等重大疾病。排除标准:病例资料不完整;治疗1个月内接受过免疫调节剂、糖皮激素等治疗;对相关药物有过敏史。
1.2 治疗方法
所有患者入院后接受复方甘草酸苷治疗,静脉滴注60 mg/d,根据病情适当减量。所有患者均采取基础治疗,即使用乳糖酸阿奇霉素治疗,加入到5%葡萄糖注射液中,1.0 mg/ml,静脉滴注3 h。再根据患者入院时的病情、病程及用药史,使用基础治疗方案联合雷公藤片、甲氨蝶呤片、阿维A胶囊等药物进行治疗。
1.3 观察指标
观察患者的基本资料,如性别、年龄、体重、病程、病史、发病因素、发病规律等,再对比分析治疗前后患者的白细胞升高、发热、高血脂比例,以及患者住院时间、无新发脓包时间、体温恢复正常时间等指标。
1.4 统计学方法
采用统计学工具SPSS19.0对数据结果进行分析,计量资料采用t检验,计数资料采用X2检验分析,P < 0.05表示具有统计学差异。
2 结果
2.1 两组患者的资料情况对比
有无甲损害和年龄、体重、性别等关系密切。观察组的男性比例、平均年龄、平均体重等均明显高于对照组,且差异具有统计学意义,即P < 0.05。然而,观察组与对照组的家族病史、发病诱因、季节性发病等均无显著性差别,即P >0.05。结果如表1所示。