重症多形红斑与中毒性表皮坏死松解症的临床分析

摘要

Objective To study the general rule of the development of Slevens-Johnson syndrome(SJS) and toxic epidermal necrolysis (TEN) and clinical features and appropriate therapy. Methods The clinical data of hospitalized patients for 42 cases of SJS and 20 cases of TEN were reviewed retrospectively from 1998 to 2012. Results SJS and TEN had often been caused by drug reaction. The drugs most often responsible for SJS and TEN were antiepi-leptics (29. 03%) , allopurinol( 16. 13%) and antibiotics ( 16. 13%) . Mucosal damage rates of SJS and TEN are 100% . The range of lesion, the degree of damage and mucous membrane involvement were higher in TEN than in SJS. Daily maximum used of corticosteroids of TEN was higher than SJS. Conclusion SJS and TEN are usually results from a drug reaction. The indication of using allopurinol and carbamazepine should be further weighed. Corticosteroid combined IVIG have beneficial effects on severe drug eruption.%目的 探讨重症多形红斑(SJS)与中毒性表皮坏死松解症(TEN)的致病因素、发生规律、临床特点和治疗措施.方法 对42例SJS和20例TEN住院患者的临床资料进行回顾性分析.结果 SJS组和TEN组患者中,药物为最常见病因.致敏药物中排在前三位的分别是抗癫痫药(29.03%)、别嘌呤醇(16.13%)及抗生素(16.13%).SJS与TEN的黏膜损害率均为100%,TEN组的皮损范围、损害程度、黏膜病变均较SJS组更广泛、更严重,TEN的日、最大糖皮质激素用量均高于SJS.结论 药物是SJS和TEN发病最主要的原因.TEN患者较SJS患者病变广泛且严重.别嘌呤醇与卡马西平应用需谨慎,激素联合免疫球蛋白IVIG治疗有效.