中华皮肤科杂志 ›› 2025, e20240299.doi: 10.35541/cjd.20240299

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自身免疫性大疱病住院患者并发静脉血栓栓塞的危险因素回顾分析

吉祥    朱萍    黄淑黛    蒋佳怡    黄凯旋    李哲曦    杨茜    王大光   

  1. 南京医科大学第一附属医院皮肤科，南京  210029
  • 收稿日期:2024-06-03 修回日期:2024-10-09 发布日期:2025-02-08
  • 通讯作者: 王大光 E-mail:wangirwin@163.com

Analysis of risk factors for autoimmune bullous diseases complicated by venous thromboembolism during hospitalization: a retrospective analysis

Ji Xiang, Zhu Ping, Huang Shudai, Jiang Jiayi, Huang Kaixuan, Li Zhexi, Yang Xi, Wang Daguang   

  1. Department of Dermatology and Venereology, the First Affiliated Hospital with Nanjing Medical University, Nanjing 210029, China
  • Received:2024-06-03 Revised:2024-10-09 Published:2025-02-08
  • Contact: Wang Daguang E-mail:wangirwin@163.com

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摘要： 【摘要】 目的 探讨自身免疫性大疱病住院患者并发静脉血栓栓塞的危险因素。方法 回顾性分析2021年10月至2024年3月于南京医科大学第一附属医院皮肤科住院的自身免疫性大疱病患者70例，根据住院期间是否发生静脉血栓栓塞分为血栓组（13例）和对照组（57例），比较两组患者的一般资料、既往史、个人史、住院情况、治疗方法和相关实验室检查，采用t检验、Wilcoxon检验和χ2检验分析组间差异，采用多因素Logistic回归分析发生静脉血栓栓塞的危险因素。结果 血栓组的年龄（80.15 ± 8.03）岁、病程M（P25，P75）为12.00（2.00，30.00）个月、外周血D-二聚体水平M（P25，P75）为5.36（2.49，8.57） mg/L、Padua评分M（P25，P75）为5.00（4.50，8.00）分、使用人免疫球蛋白占比61.54%，均高于对照组［分别为（68.53 ± 13.52）岁、2.00（1.00，6.00）个月、0.90（0.44，1.70） mg/L、3.00 （2.00，4.00）分、17.54%］；淋巴细胞计数［（1.06 ± 0.52） × 109/L］、红细胞［（3.55 ± 0.49） × 1012/L］、血红蛋白［（113.62 ± 12.68） g/L］、总蛋白［（55.33 ± 7.28） g/L］、白蛋白［（28.86 ± 6.33） g/L］均低于对照组［分别为（1.58 ± 0.85） × 109/L、（4.16 ± 0.60） × 1012/L、（126.69 ± 16.99） g/L、（62.13 ± 6.83） g/L、（33.30 ± 4.84） g/L］，差异均有统计学意义（P < 0.05）。多因素Logistic回归分析显示，病程（OR = 1.039，95% CI：1.004 ~ 1.075）、总蛋白（OR = 0.883，95% CI：0.782 ~ 0.998）、Padua评分（OR = 2.397，95% CI：1.165 ~ 4.930）是自身免疫性大疱病住院患者并发静脉血栓栓塞的影响因素（P < 0.05）。结论 病程长、总蛋白低、Padua评分高的自身免疫性大疱病住院患者更易发生静脉血栓栓塞。

关键词: 天疱疮, 类天疱疮, 大疱性, 静脉血栓栓塞, 危险因素, 自身免疫性大疱病

Abstract: 【Abstract】 Objective To explore risk factors for autoimmune bullous diseases complicated by venous thromboembolism （VTE） during hospitalization. Methods A retrospective analysis was conducted on 70 patients with autoimmune bullous diseases who were hospitalized in the Department of Dermatology, the First Affiliated Hospital with Nanjing Medical University from October 2021 to March 2024. According to whether VTE occurred during hospitalization, these patients were divided into a VTE group （13 cases） and a control group （57 cases）. General information, medical history, personal history, hospitalization status, treatment methods, and related laboratory examination results were compared between the two groups. The t test, Wilcoxon test, and chi-square test were used to analyze the differences between the groups, and a multivariate logistic regression model was used to analyze the risk factors for VTE. Results Compared with the control group, the VTE group showed increased patients′ age （80.15 ± 8.03 years vs. 68.53 ± 13.52 years）, course of disease （M［P25, P75］: 12.00 ［2.00, 30.00］ months vs. 2.00 ［1.00, 6.00］ months）, peripheral blood levels of D-dimer （M［P25, P75］: 5.36 ［2.49, 8.57］ mg/L vs. 0.90 ［0.44, 1.70］ mg/L）, Padua scores （M［P25, P75］: 5.00 ［4.50, 8.00］ points vs. 3.00 ［2.00, 4.00］ points）, and the proportion of patients receiving human immunoglobulin therapy （61.54% vs. 17.54%）, but decreased lymphocyte count （1.06 × 10?/L ± 0.52 × 10?/L vs. 1.58 × 10?/L ± 0.85 × 10?/L）, red blood cell count （3.55 × 1012/L ± 0.49 × 1012/L vs. 4.16 × 1012/L ± 0.60 × 1012/L）, levels of hemoglobin （113.62 ± 12.68 g/L vs. 126.69 ± 16.99 g/L）, total protein （55.33 ± 7.28 g/L vs. 62.13 ± 6.83 g/L）, and albumin （28.86 ± 6.33 g/L vs. 33.30 ± 4.84 g/L）, with statistically significant differences （all P < 0.05）. Multivariate logistic regression analysis showed that the course of disease （OR = 1.039, 95% CI: 1.004 — 1.075）, total protein levels （OR = 0.883, 95% CI: 0.782 — 0.998）, and Padua scores （OR = 2.397, 95% CI: 1.165 — 4.930） were factors influencing the occurrence of VTE in hospitalized patients with autoimmune bullous diseases （all P < 0.05）. Conclusion Hospitalized patients with autoimmune bullous diseases who had a long course of disease, low total protein levels, and high Padua scores were prone to develop VTE.

Key words: Pemphigus, Pemphigoid, bullous, Venous thromboembolism, Risk factors, Autoimmune bullous diseases

引用本文

吉祥 朱萍 黄淑黛 蒋佳怡 黄凯旋 李哲曦 杨茜 王大光. 自身免疫性大疱病住院患者并发静脉血栓栓塞的危险因素回顾分析[J]. 中华皮肤科杂志, 2025,e20240299. doi:10.35541/cjd.20240299

Ji Xiang, Zhu Ping, Huang Shudai, Jiang Jiayi, Huang Kaixuan, Li Zhexi, Yang Xi, Wang Daguang. Analysis of risk factors for autoimmune bullous diseases complicated by venous thromboembolism during hospitalization: a retrospective analysis[J]. Chinese Journal of Dermatology,2025,e20240299. doi:10.35541/cjd.20240299