Retrospective Analysis Of 72 Cases Of Bullous Pemphigoid

Objective: To analyze the clinical features and therapy of patients with various degree of bullous pemphigoid,and explore the relationship between age,gender,basic diseases,laboratory indicators and the severity of BP,compare the effects of hormone,immunosuppressive agents,immunoglobulin on the efficacy of BP.So as to guide the clinical treatment of BP.Methods:Clinical datas of 72 patients with BP from January 2014 to September2016 in the Department of Dermatology,the First Affiliated Hospital of Dalian Medical University were retrospectively analyzed,Including age,gender,basic dis-eases,laboratory indicators,skin lesions,histopathology,immunofluorescence,mis-diagnosis and treatment.Comparing the correlation between the factors and the severity of the disease,the difference of curative effect between different therapy.Result:There were 10 mild patients(13.9%),38 moderate patients(52.8%),24 severe patients(33.3%).72 patients,45 males and 27 females,were enrolled,whose average age was 77.15±9.34 years old.With aggravating of the disease,the degree of itching intensified.The patients of BP often appear variety of basic diseases at the same time.In this study,46 patients had neurological disease,including stroke,Alzheimer's disease,Parkinson's syndrome,etc.There were 40 cases of cardiovascular disease,mainly coronary heart disease,hypertension,arrhythmia,heart failure and so on.67 cases of pathological biopsy and direct immunofluorescence were performed in the study.44 cases(65.7%)showed positive fluorescence of basement membrane zone.5 cases with no pathology and immunofluorescence,were detected anti-BP230 antibody and anti-BP180 antibody by ELISA method,and the result were higher than the normal value.35 patients were tested for anti-BP180 antibody and anti-BP230 antibody,34 patients(97.1%)with elevated anti-BP180 antibody,23 cases(65.7%)with elevated anti-BP230 antibody.There were no negative results of two indexes.The total number and percentage of eosinophils increased with the aggravation of the disease.But there was no statistical differe-nce between the moderate and severe groups(P>0.05);Serum albumin level had significant difference between the three groups(P<0.05).With aggravating of the disease,the serum albumin level reduced.Glucocorticoid,immunosuppressants,immunoglobulin were the main methods for treating BP.Combined with immunogl-obulin,the initial dose and controlled dose was reduced than hormone therapy alone.The initial dose and control dose of glucocorticoid in three groups were significant difference.Conclusion:1.BP primarily affected old people,especially 70 years old,and the incidence in males is often higher than in females.2.BP patients often accompanied by one or more complications,stroke of neurological diseases was the most common accompanied disease.3.The level of serum albumin was negatively correlated with the severity of BP.4.Excepting histopathology and immunofluorescence,BP180 ELISA and BP230 ELISA can be used as an important basis for the diagnosis of BP.5.With aggravating of the disease,the control dose of hormone increased gradually.6.Hormone shock therapy can be used to the cases without contraindications but routine treatment was invalid.