Analysis Of Influencing Factors Of Severity Of Bullous Pemphigoid Patients

Background: Bullous pemphigoid（BP）is a common autoimmune subcutaneous Bullous disease.As a chronic disease,BP has a negative impact on the quality of life.According to statistics,the annual mortality rate of BP patients is between 20% and40%,and the incidence rate is also increasing year by year.At present,glucocorticoid is still the most important and effective method for treating BP,and the specific dose of glucocorticoid should be determined according to the severity of different patients’ conditions in clinical practice.At present,for the severity score of autoimmune bullous disease,the commonly used clinical evaluation indicators are autoimmune bullous disease severity Score（ABSIS）and bullous pemphigoid disease area index score（BPDAI）.At the same time,some researchers have developed different scoring methods for bullous pemphigoid according to individual research needs.At present,these grading methods,especially BPDAI,are complicated and are mainly based on patients’ surface affected area and clinical symptoms.The condition of bullous pemphigoid patients is usually severe,and there are many clinical changes.Early judgment of the severity of the disease can improve the curative effect and prognosis of patients.Therefore,objective,effective and reliable evaluation index of disease severity is indispensable,which can not only predict the change of disease,but also be very important for the grasp of therapeutic dose and evaluation of curative effect.Scholars at home and abroad have done a lot of studies on the related factors affecting the severity of BP patients.Many studies show that the severity of BP is positively correlated with the number of peripheral blood eosinophils（EOS）and the level of anti-BP180 antibody,but not with the level of anti-BP230 antibody.Some foreign scholars have also shown that the level of anti-BP180 and anti-BP230,the severity of tissue inflammation and the increase of skin eosinophils are significantly correlated with the severity of BP.In most studies of PATIENTS with BP,serum total Ig E level and anti-basal membrane band antibody level are positively correlated with disease activity,but the relationship between serum total Ig E level and disease severity remains controversial.At present,many scholars have carried out retrospective analysis on the clinical data of PATIENTS with BP,but the analysis on the influencing factors related to the severity of BP disease with a large sample size is not comprehensive enough,and there are some differences in data from different studies.On this basis,the clinical data of216 BP patients hospitalized in our department were retrospectively analyzed,the distribution differences of various clinical data among different groups of patients were statistically analyzed,and the correlation between different factors and disease severity score was analyzed.It aims to be more efficient in judging the severity of BP patients,and to timely monitor the changes of the disease,so as to provide more help for the treatment of patients.Objective: To investigate the potential factors affecting disease severity in patients with bullous pemphigoid.Methods: Clinical data of inpatients with bullous pemphigoid in the First Affiliated Hospital of Anhui Medical University from 2018 to 2021 were collected and analyzed retrospectively.The patients were divided into mild,moderate and severe groups,and the differences in clinical data distribution between the different groups were statistically analyzed,and the correlation between the different factors and the disease severity score was analyzed.Results: 216 patients with bullous pemphigoid were included in the analysis,including51 patients with mild pemphigoid（23.6%）,132 patients with moderate pemphigoid（61.1%）,and 33 patients with severe Pemphigoid（15.3%）.Between patients with different disease severity,Hospitalization days,mucosal involvement,whether merger hypoalbuminemia,hypocalcemia,fight BP180 antibody is masculine gender,peripheral eosinophil count on admission,the pathological presence of typical eosinophil infiltration,glucocorticoid and largest amount control whether or not to use the distribution of immunosuppressant,support treatment differences statistically significant（P < 0.05）.Severity scores of bullous pemphigoid patients were correlated with length of stay（r = 0.459,P < 0.001）,peripheral blood eosinophil count at admission（r=0.457,P<0.001）,maximum control level of glucocorticoid（r = 0.645,P< 0.001）and anti-BP180 level（r = 0.376,P = 0.012）was positively correlated.Conclusion: Patients with bullous pemphigoid with more severe disease,longer hospital stay,the maximum control of glucocorticoid.Eosinophil count and anti-BP180 level in peripheral blood at admission may be the key factors affecting the severity of disease in patients with BP,which can provide help for clinical evaluation of patients’ condition and prediction of therapeutic dose.