中华皮肤科杂志 ›› 2006, Vol. 39 ›› Issue (1): 41-43.

• 论著 • 上一篇    下一篇

大剂量静脉注射免疫球蛋白治疗25例重症皮肤病的临床分析

朱国兴1, 陆春1, 赖维1, 冯佩英1, 顾有守2   

  1. 1. 中山大学附属第三医院皮肤性病科 广州 510630;
    2. 广东省皮肤性病防治中心
  • 收稿日期:2005-03-03 发布日期:2006-01-15

High-dose intravenous immunoglobulin in the treatment of some severe skin diseases:a clinical analysis

ZHU Guo-xing1, LU Chun1, LAI Wei1, FENG Pei-ying1, GU You-shou2   

  1. Department of Dermatology and Venereology, the Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou 510630, China
  • Received:2005-03-03 Published:2006-01-15

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摘要： 目的 探讨大剂量静脉注射免疫球蛋白(大剂量IVIg)治疗中毒性表皮坏死松解症、药物超敏综合征、结缔组织病、自身免疫性疱病、急性移植物抗宿主病等重症皮肤病的临床疗效和不良反应.方法 应用免疫球蛋白0.4g·kg-1·d-1静脉滴注,每个疗程时间均为连续5d,治疗25例重症皮肤病.结果 大剂量IVIg对这25例重症皮肤病疗效各有差异,其中21例重症患者疗效较好,尤其是急性发病的中毒性表皮坏死松解症和药物超敏综合征效果最好;1例成人皮肌炎患者和2例老年大疱性类天疱疮患者未得到缓解,1例急性移植物抗宿主病患者死亡;仅3例患者出现轻微头痛、血压升高等.结论 大剂量IVIg是治疗某些重症免疫性皮肤病的有效手段,对于缩短病程、减少糖皮质激素和免疫抑制剂的用量、预防感染等方面疗效明显.

关键词: 免疫球蛋白类, 表皮坏死松解症,中毒性, 药物过敏, 结缔组织疾病, 皮肤疾病,水疱大疱性, 移植物抗宿主病

Abstract: Objective To analyze the therapeutic outcomes and adverse effects of high-dose intravenous immunoglobulin (hd-IVIg) in the treatment of some severe skin diseases (toxic epidermal necrolysis,drug hypersensitivity syndrome,connective tissue disease,autoimmune bullous disease,acute graft-versus-host disease).Methods Twenty-five cases of severe skin diseases were treated with hd-IVIg (0.4 g/kg/day for a course of 5 days).Results The therapeutic outcomes were different from each other.Of all the cases,21 improved,especially those of acute onset of toxic epidermal necrolysis and drug hypersensitivity syndrome;1 adult dermatomyositis and 2 elder bullous pemphigoid were not relieved.A patient with acute graft-versus-host disease died.Three patients presented with minor adverse effects (headache and blood pressure rising).Conclusions hd-IVIg is effective and safe in the treatment of some severe skin diseases.More importantly,it has a substantial effect on shortening disease course and decreasing the dosage of glucocorticoids and immunosuppressants as well as on preventing infections.

Key words: Immunoglobulin, Epidermal necrolysis,toxic, Drug hypersensitivity, Connective tissue diseases, Skin disease,bullous, Graftvshost disease