123例节段型白癜风的临床特点分析

发布时间：2018-01-11 20:45

本文关键词：123例节段型白癜风的临床特点分析　出处：《吉林大学》2017年硕士论文　论文类型：学位论文

【摘要】：背景白癜风在临床上比较常见,是一种获得性、持久性的皮肤粘膜色素脱失性疾病,世界范围内的人群发病率约为0.5%~1%。其发病与地域、性别无关,任何年龄均可患病,但大多数患者在青少年期发病。根据2012年白癜风全球问题共识大会(The Vitiligo Global Issues Consensus Conference,VGICC)及专家讨论,目前主要将白癜风分为四种类型:即节段型、非节段型、混合型以及未定型(原称局限型)。其中非节段型包括散发型、泛发型、粘膜型以及面肢端型。在临床工作中,常将非节段型、混合型、未定型统一归为寻常型。目前,国内关于节段型白癜风的临床特点方面的研究较少。目的收集白癜风患者的临床资料,分析节段型和寻常型白癜风患者的临床特点的差异,以此了解节段型白癜风的临床特征。材料与方法使用统一标准的白癜风调查表,收集自2014年10月1日至2015年9月30日期间就诊于我院皮肤科门诊的白癜风患者的临床和流行病学资料。入选标准:1所有患者均由副主任医师及以上的专家确诊,并已排除其他色素减退性疾病;2临床诊断标准则参考赵辨主编的《临床皮肤病学》中的关于白癜风的诊断标准;3患者的地域、种族、性别、年龄不限。排除资料记录不完整的患者。收集合格的白癜风患者的临床资料共计1015例,其中节段型患者123例,寻常型患者892例(包括非节段型724例,混合型28例,未定型140例)。将收集并整理完成后的资料输入社会科学统计软件包SPSS20.0进行统计学分析。结果1.节段型白癜风患者共计123例,占同期全部患者的12.1%。其中男性59例,女性64例,男女发病比例0.92:1。节段型白癜风患者的平均发病年龄为16.30±11.59岁,寻常型白癜风患者平均发病年龄为22.24±14.80岁,两者比较差异有统计学意义(t=5.128,P0.01)。在20岁之前发病的节段型患者共计86例,占69.9%。临床最常见的发病部位为面颈部,其次为躯干。2.在发病年龄、发病部位、皮损面积、发病季节、伴发疾病、白癜风家族史等方面,男女节段型患者的比较均无统计学差异。3.单节段型白癜风最常见,共113例,占91.9%。皮损累及身体左右侧无统计学差异。4.伴有自身免疫性疾病的节段型患者的平均发病年龄(25.11±13.27)大于不伴有自身免疫性疾病的患者的平均发病年龄(15.17±10.79),两者比较差异有统计学意义(t=3.226,P=0.009)。5.12例(9.8%)节段型白癜风患者有阳性家族史,有家族史的患者平均发病年龄(13.60±10.18)较无家族史的患者平均发病年龄(16.60±11.74)早,但差异(t=0.953,P=0.357)无统计学意义。有家族史的节段型患者在发病部位、发病季节、皮损面积等方面与无家族史的患者相比,无明显差异。6.与寻常型白癜风进行比较,节段型白癜风的阳性家族史少,伴发晕痣、白发症及其他自身免疫性疾病的情况均少见(P0.05)。结论1.男女节段型白癜风患者的临床特点无显著差异;2.单节段型白癜风最常见,皮损累及身体左右侧无差异;3.与寻常型白癜风相比较,节段型白癜风的发病年龄更早,阳性家族史少,伴发晕痣、白发症及自身免疫性疾病少。
[Abstract]:Background vitiligo is more common in clinic, is an acquired, persistent skin depigmentation disease, the worldwide incidence rate is about 0.5%~1%. and the incidence of the region, regardless of gender, the prevalence of any age, but most patients in juvenile onset. According to the 2012 global consensus conference (The vitiligo Vitiligo Global Issues Consensus Conference, VGICC) and experts to discuss, at present mainly classified four types: segmental and non segmental type, mixed type and undifferentiated (formerly known as localized). The non segmental type including sporadic, pan hair, face and mucosal acral. In clinical work, often non segmental type, mixed type, unshaped unified into ordinary type. At present, there is less research on the clinical features of segmental vitiligo. The clinical data collection of vitiligo patients, divided Patients with vitiligo vulgaris and segmental analysis of the clinical characteristics of the differences, in order to understand the clinical features of segmental vitiligo. Materials and methods use standard of vitiligo questionnaire, collected from October 1, 2014 to September 30, 2015 in the Department of dermatology in our hospital vitiligo patients with clinical and epidemiological data of all patients. Inclusion criteria: 1 the deputy director of physicians and more experts diagnosed and excluded other hypopigmented diseases; 2 clinical diagnosis standard reference Zhao Bian, "clinical dermatology > about vitiligo diagnostic criteria; 3 patients in the region, race, gender, age is not restricted. Records of patients with incomplete exclusion clinical data were collected. The qualified vitiligo patients a total of 1015 cases, including 123 cases of patients with segmental, 892 cases of patients with vulgaris (including non segmental type in 724 cases, 28 cases of mixed type, and 140 undefined To collect and collate cases). After the completion of the data into the statistical package for social science SPSS20.0 for statistical analysis. Results 1. of segmental vitiligo patients were 123 cases, accounted for 12.1%. of all patients 59 cases were male, 64 were female, the average age of onset of male and female incidence ratio of 0.92:1. segmental type vitiligo patients was 16.30 + 11.59 years old, the average age of onset of vitiligo was 22.24 + 14.80, there was significant difference between the two groups (t=5.128, P0.01). Patients with segmental onset before the age of 20, a total of 86 cases, accounting for the most common site for clinical 69.9%. neck, followed by trunk.2. in age of onset. Location and lesion area, seasonal incidence, associated diseases, family history of vitiligo, and segmental patients were no significant differences of.3. single segment the most common type of vitiligo, a total of 113 cases, accounting for 91.9%. lesions involving the body No significant difference between the left and right side.4. associated with autoimmune diseases the average age of the patients with segmental (25.11 + 13.27) than the average age of onset was not associated with autoimmune disease patients (15.17 + 10.79), the difference was statistically significant (t=3.226 P= 0.009).5.12 (9.8%) cases of patients with segmental type of vitiligo have a positive family history, the average age of patients with family history (13.60 + 10.18) than the average age of patients without family history (16.60 + 11.74) early, but the difference (t=0.953, P=0.357). There is no significant seasonal segment with a family history of the disease, in the pathogenesis of the site, the lesion area as compared with patients with no family history, no significant difference between.6. and vitiligo vulgaris were compared, segmental vitiligo positive family history, halo nevi, white hair disease and other autoimmune diseases are rare (P0.05). Conclusion: 1. No significant differences in clinical characteristics of vitiligo patients and 2. segments; the most common single segmental vitiligo, no difference between the involvement of left and right side body; 3. with vitiligo vulgaris compared to earlier age of onset of segmental vitiligo, positive family history, halo nevi, white hair disease and autoimmune diseases less.

【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R758.41

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