本文選題：泛發(fā)性膿皰型銀屑病 + 回顧性臨床分析�。� 參考：《寧夏醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的初步探討泛發(fā)性膿皰型銀屑病的流行病學(xué)特點(diǎn)、臨床特征、實(shí)驗(yàn)室檢查結(jié)果、治療方案,為臨床更好地預(yù)防和治療該病提供參考意見。方法收集整理2005年1月1日至2015年12月31日寧夏醫(yī)科大學(xué)總醫(yī)院、寧夏回族自治區(qū)人民醫(yī)院住院治療的所有泛發(fā)性膿皰型銀屑病患者的病案資料,共159例,對(duì)所有患者的病歷資料進(jìn)行回顧性分析。探討泛發(fā)性膿皰型銀屑病的流行病學(xué)特點(diǎn),臨床特征,分析實(shí)驗(yàn)室檢查結(jié)果,比較不同治療方案,提出如何更好地預(yù)防和治療泛發(fā)性膿皰型銀屑病。結(jié)果159例泛發(fā)性膿皰型銀屑病患者中,有17例患者為反復(fù)住院(2~7次),故實(shí)際患者128人,其中男性多于女性,男女比例為1:0.86。最小發(fā)病年齡6個(gè)月,最大發(fā)病年齡78歲,平均發(fā)病年齡為37.5±18.8歲,未成年人21人,成年人107人。首次發(fā)病時(shí)有102人既往有尋常型銀屑病病史(79.7%)。128人中23人有尋常型銀屑病家族史。159例患者中,有明確發(fā)病誘因者101例(63.5%),其中糖皮質(zhì)激素不當(dāng)使用誘發(fā)31例,上呼吸道感染誘發(fā)23例,中草藥誘發(fā)18例。入院時(shí)體溫37.2℃有68例(42.8%),治療后退熱時(shí)間1~46天,平均3.4±6.1天。入院后病情評(píng)估輕度有35人(22%),中度107人(67.3%),重度17人(10.7%)。實(shí)驗(yàn)室檢查中,有76例患者白細(xì)胞升高;12例患者ALT升高,7例患者AST升高;101例有低蛋白血癥;65例患者血鈣降低。23例行膿皰細(xì)菌培養(yǎng)的患者中有14例陽性,分別為表皮葡萄球菌、金黃色葡萄球菌、人葡萄球菌、草綠色鏈球菌、枯草芽孢桿菌、棒桿菌。46例行血培養(yǎng)的患者中有6例陽性,分別為凝固酶陰性葡萄球菌、金黃色葡萄球菌、表皮葡萄球菌、緩慢葡萄球菌。治療方案為復(fù)方甘草酸苷制劑、維A酸類藥物、糖皮質(zhì)激素、甲氨蝶呤、雷公藤等單獨(dú)或聯(lián)合應(yīng)用,經(jīng)治療后,平均膿皰消退時(shí)間為10.2±7.5天,平均住院日為18天。結(jié)論1.近11年來我區(qū)泛發(fā)性膿皰型銀屑病住院患者人數(shù)呈上升趨勢(shì),其中男性多于女性。2.常見發(fā)病誘因多為糖皮質(zhì)激素、中草藥的不當(dāng)使用及上呼吸道感染。3.實(shí)驗(yàn)室檢查大多數(shù)患者白細(xì)胞和中性粒細(xì)胞升高,血鈣降低,血清白蛋白降低。4.治療方法應(yīng)多樣化、個(gè)體化,維甲酸類藥物、甲氨蝶呤等聯(lián)合復(fù)方甘草酸苷制劑可降低藥物副作用,提高療效。
[Abstract]:Objective to explore the epidemiological characteristics, clinical features, laboratory results and treatment plan of generalized pustular psoriasis (Psoriasis) so as to provide reference for clinical prevention and treatment of Psoriasis. Methods A total of 159 cases of generalized pustular psoriasis were collected and sorted from January 1, 2005 to December 31, 2015 in the General Hospital of Ningxia Medical University and the people's Hospital of Ningxia Hui Autonomous region. The medical records of all patients were analyzed retrospectively. To investigate the epidemiological and clinical characteristics of generalized pustular psoriasis, to analyze the results of laboratory examination, to compare different treatment schemes, and to propose how to better prevent and treat generalized pustular psoriasis. Results among 159 patients with generalized pustular psoriasis, 17 patients were hospitalized twice and 7 times, so 128 patients were in fact, male was more than female, the ratio of male to female was 1: 0.86. The minimum onset age was 6 months, the maximum onset age was 78 years old, the average onset age was 37.5 鹵18.8 years, 21 minors and 107 adults. At the first onset, 102 patients had a history of psoriasis vulgaris (79.7%), among them 23 cases had a family history of psoriasis vulgaris (159 cases), 101 cases had definite inducement, among which 31 cases were induced by improper use of glucocorticoid. 23 cases were induced by upper respiratory tract infection and 18 cases by Chinese herbal medicine. 68 patients with body temperature 37.2 鈩，

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