Combined use of cyclosporine in the treatment of Stevens–Johnson syndrome/toxic epidermal necrolysis
Combined use of cyclosporine in the treatment of Stevens–Johnson syndrome/toxic epidermal necrolysis
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DOI：
10.1111/1346-8138.16369
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发表时间：
2022-04
期刊：
影响因子：
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通讯作者：
Rentao Yu;Shuang Chen;Yun Pan;Chunrong Ma;Li Hu;Aijun Chen;Bin Wei
中科院分区：
文献类型：
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作者：
Rentao Yu;Shuang Chen;Yun Pan;Chunrong Ma;Li Hu;Aijun Chen;Bin Wei
环孢素治疗Stevens-Johnson综合征（SJS）/中毒性表皮坏死松解症（TEN）的确切疗效仍需更多临床资料的证据。本研究旨在比较环孢素联合糖皮质激素（GC）/静脉注射免疫球蛋白G（IVIG）治疗TEN的有效性和副作用。共入组46例SJS/TEN患者，并根据所用治疗药物分为两组。收集并比较两组患者的临床特征、干预措施、结局和疾病进展。在我们的队列中，7例患者最终死亡，总病死率为15.2%，但两组之间无差异（p = 0.557）。出院时，中毒性表皮坏死（SCORTEN）的中位评分从入院时的2.0降至1.0，中位体表面积从入院时的32.0%降至9.5%。环孢素组患者的上皮再形成面积率高于非环孢素组患者（p < 0.05）。与非环孢菌素组相比，环孢菌素显著缩短了住院时间（19.0 vs. 13.0天，p = 0.019）和全身感染率（71.4% vs. 36.0%，p = 0.017）。SCORTEN是死亡的唯一显著风险因素，风险比为1.96（1.17-3.31，p = 0.011）。结论：联合使用环孢素可减少全身感染的发生，促进上皮再形成。
The exact efficacy of cyclosporine in the treatment of Stevens–Johnson syndrome (SJS)/toxic epidermal necrolysis (TEN) still needs evidence from more clinical data. This study was designed to compare the effectiveness and side‐effects of combined use of cyclosporine in the treatment TEN with glucocorticoids (GC)/i.v. immunoglobulin G (IVIG). A total of 46 patients with SJS/TEN were enrolled and classified into two groups based on the therapeutic drugs used. Clinical characteristics, interventions, outcomes, and disease progressions were collected and compared between the two groups. In our cohort, seven patients eventually died and the overall fatality rate was 15.2%, but there was no difference between the two groups (p = 0.557). On discharge, the median SCORe of Toxic Epidermal Necrosis (SCORTEN) fell from 2.0 at admission to 1.0 and the median body surface area detached fell from 32.0% at admission to 9.5%. Patients in the cyclosporine group had a higher rate of re‐epithelialized area than patients in the non‐cyclosporine group (p < 0.05). Cyclosporine significantly reduced the length of stay (19.0 vs. 13.0 days, p = 0.019) and the rate of systemic infection (71.4% vs. 36.0%, p = 0.017) compared with the non‐cyclosporine group. SCORTEN was the only significant risk factor for death and the risk ratio was 1.96 (1.17–3.31, p = 0.011). Conclusively, the combined use of cyclosporine could reduce the occurrence of systemic infection and accelerate the re‐epithelialization.