成人アトピー性皮膚炎の入院療法における病勢マーカーの検討  [in Japanese] Study of Disease Markers in Adult Patients with Atopic Dermatitis Receiving Inpatient Therapy  [in Japanese]

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Author(s)

    • 鈴木 琢 Suzuki Taku
    • 東邦大学医療センター大橋病院皮膚科 Department of Dermatology, Toho University Ohashi Medical Center
    • 早出 恵里 Sode Eri
    • 東邦大学医療センター大橋病院皮膚科 Department of Dermatology, Toho University Ohashi Medical Center
    • 向井 秀樹 Mukai Hideki
    • 東邦大学医療センター大橋病院皮膚科 Department of Dermatology, Toho University Ohashi Medical Center

Abstract

成人アトピー性皮膚炎(Atopic dermatitis:AD)の入院療法における病勢マーカーについて検討した.対象は当院皮膚科に2009年3月から2010年1月までに,急性増悪ないし重症例のため入院加療した成人AD 26名である.年齢は17~48歳(平均値±SD:28.7±8.0歳),性別は男性10名,女性16名で,入院期間は7~25日(13.0±3.5日)である.方法は,入院時(第2病日)と退院時の早朝(7時~8時)に血清コルチゾール値,血漿adrenocorticotropic hormone(ACTH)値,血清thymus andactivation-regulated chemokine(TARC)値,血清lactate dehydrogenase(LDH)値,末梢血好酸球数を測定し,比較検討した.さらに,日本皮膚科学会(日皮会)AD重症度分類,痒みのVisual analoguescale(VAS)値,Skindex-16,Dermatology Life Quality Index(DLQI)に関しても比較検討した.結果は,入院時に低値を示した血清コルチゾール値と血漿ACTH値はともに有意な増加を示し,入院時に高値を示した血清TARC値や血清LDH値は有意に減少した.一方,末梢血好酸球数は減少するも有意差を認めなかった.また,日皮会AD重症度分類,Skindex-16,DLQIおよび痒みのVAS値は有意に減少した.今回の検討で,2週間程の短期入院における血中病勢マーカーは血清コルチゾール値,血漿ACTH値,血清TARC値,血清LDH値が有用であった.これらの中で,血清TARC値は全例において入院時から退院時に減少し,測定幅を考慮すると,血清TARC値が重症度と改善度の評価を最も反映するマーカーと考えた.その他のマーカーとして日皮会AD重症度分類,Skindex-16,痒みのVAS値およびDLQIが有用であった.

We studied some disease markers in adult patients with atopic dermatitis (AD) receiving inpatient therapy. The subjects were 26 adult patients (age [mean±SD], 28.7±8.0 years) with AD who were admitted to our hospital. They were hospitalized for 13.0±3.5 days. The levels of serum cortisol, plasma adrenocorticotropic hormone (ACTH), serum thymus and activation-regulated chemokine (TARC), and serum lactate dehydrogenase(LDH), as well as the peripheral blood eosinophil counts were measured on the days of hospitalization and discharge. Moreover, the scores of the severity classification of AD by the Japanese Dermatological Association, itching visual analogue scale (VAS), Skindex-16, and Dermatology Life Quality Index (DLQI) were comparatively examined. The results showed significant increases in the cortisol and ACTH levels and significant decreases in the TARC and LDH levels; and in the scores of the severity classification of AD, Skindex-16, itching VAS and DLQI; the peripheral eosinophil counts did not change significantly. This study showed that cortisol, ACTH, TARC, and LDH levels and the scores of the severity classification of AD, Skindex-16, itching VAS and DLQI were useful as disease markers for patients hospitalized for a short period of time, such as 2 weeks.

Journal

  • The Japanese Journal of Dermatology

    The Japanese Journal of Dermatology 123(2), 133-141, 2013

    Japanese Dermatological Association

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