某皮肤病医院寻常型银屑病患者流行病学特征分析

发布时间：2018-03-02 14:38

本文选题：寻常型银屑病　切入点：流行病学　出处：《山东大学》2011年硕士论文　论文类型：学位论文

【摘要】：一、研究背景银屑病是由遗传和环境等多种因素相互作用引起的慢性炎症性皮肤病,具有易复发、病程长的特点,严重影响患者的身心健康。银屑病的发病率在世界各地有明显不同,与种族、地理位置、环境等因素有关。根据临床表现银屑病可分为寻常型、脓疱型、红皮病型及关节病型,其中寻常型银屑病最常见。根据发病年龄也可将银屑病分为两型,早发型(Ⅰ型)患者在40岁前发病,晚发型(Ⅱ型)患者在40岁后发病。1984年中国调查发现银屑病的患病率为0.123%。2010年中国六个不同省市的银屑病流行病学调查结果显示,目前银屑病的患病率已经增长为0.47%。不同地区、不同人群中银屑病的临床流行病学特征可能不尽相同,本地区尚缺乏银屑病患者的流行病学资料。为了给大规模的流行病学调查提供参考数据,需要对现阶段就诊银屑病患者的流行病学特征进行了解。二、研究目的通过对某皮肤病医院门诊就诊寻常型银屑病患者进行调查分析,总结描述本地区寻常型银屑病患者的临床流行病学特征,为银屑病的流行病学研究、预防和治疗提供对策依据。三、材料与方法利用某皮肤病医院信息系统(HTS)中的门诊寻常型银屑病患者数据库资料,对4523例患者进行临床流行病学调查。调查内容包括：性别、年龄、首次发病年龄、病程、受累部位、皮损形态、病情分期、银屑病面积和严重程序指数(PASI)、发病季节、诱发因素、早发型和晚发型、家族史、关节症状等。利用SPSS17.0软件对数据进行统计学分析,得出相关结论。四、结果 1、寻常型银屑病患者中男女比例为1.43：1(2662：1861)； 2、首次发病年龄从出生8天到85岁,平均26.99±13.74岁；男性患者的平均首次发病年龄为27.53±12.69岁,女性患者的平均首次发病年龄为26.23±15.10岁,男性首次发病年龄晚于女性首次发病年龄(P0.05)。男性首次发病年龄的高峰段在20-30岁之间,女性首次发病年龄的高峰段在10-20岁之间。 3、早发型银屑病患者占大多数,为83.53%(3778/4523),晚发型银屑病患者占16.47%(745/4523)； 4、病程从3天到60年,平均7.43±8.65年,中位数为4.08年；男性患者的平均病程为7.37±8.56年,中位数为4.12年；女性患者的平均病程为7.51±8.78年,中位数为4.07年,无显著性差异(P0.05) 5、患者多部位皮肤受累较常见。最多见的是下肢,占89.74%(4059/4523)；其次是上肢,占86.09%(3894/4523)。躯干占83.44%(3774/4523),头部占80.34%(3634/4523)。受累最少的部位是黏膜,仅占1.06%(48/4523)。 6、皮损形态以斑块状47.29%(2139/4523)最为常见,其次是点滴状23.13%(1406/4523)、钱币状22.48%(1017/4523)；最少见的是带状0.22%(10/4523)。 7、稳定期患者最多见,占57.42%(2597/4523)；进展期患者占21.98%(994/4523),消退期患者占21.93%(992/4523)； 8、所有患者的平均PASI评分为6.33±5.62：早发型患者的平均PASI评分为6.13±5.21,晚发型患者的平均PASI评分为7.33±7.21,两者有显著性差异(P0.05)： 9、有家族史的患者占24.23%(1093/4523)；26.18%(989/3778)早发型患者有家族史,13.83%(103/745)晚发型患者有家族史,两者有显著性差异(P0.05)； 10、最常见的诱发因素为生物因素43.99%(494/1123)和季节因素31.43%(353/1123)；发病或加重季节以冬季47.88%(169/353)、春季47.31%(167/353)为主,其次是秋季21.25%(75/353),夏季最少12.18%(43/353)； 11、14.87%(673/4523)患者有关节症状,5.81%(112/1928)患者确诊合并关节病型银屑病。五、结论寻常型银屑病患者中男性多于女性；首次发病年龄存在性别差异,男性晚于女性；早发型患者显著多于晚发型患者；多数银屑病患者病程较长；受累部位以四肢最常见；皮损形态以斑块状、点滴状居多；稳定期患者占多数；病情以轻中度为主(PASI10)；遗传因素在早发型患者发病中的作用较晚发型重要；银屑病患者的诱发因素以生物因素和季节因素最常见,多数患者冬春季病情较重,夏秋季减轻；有关节症状的寻常型银屑病患者需要警惕合并关节病型银屑病的可能。
[Abstract]:First, research background
Psoriasis is a combination of genetic and environmental factors such as the interaction of chronic inflammatory skin disease caused by, is easy to relapse, the characteristics of long duration, serious impact on the patient's physical and mental health. The incidence of psoriasis is significantly different, and the race, the geographical position in the world, the environment and other factors. According to the clinical manifestations of psoriasis can be divided into vulgaris, pustular, erythrodermic and arthropathic psoriasis vulgaris, the most common. According to the age of onset of psoriasis can also be divided into two types (type I) in patients with early onset before the age of onset in 40, late onset (type II) at the age of 40 years after the onset of.1984 years China survey found psoriasis the prevalence of 0.123%.2010 in six different provinces of the Chinese psoriasis epidemiological survey, at present, the prevalence of psoriasis in different regions has increased to 0.47%., the clinical epidemiological characteristics of psoriasis in different populations It may not be the same. There is still lack of epidemiological data of psoriasis in this area. In order to provide reference data for large-scale epidemiological investigation, we need to understand the epidemiological characteristics of psoriasis patients at this stage.
Two, the purpose of the study
Objective to investigate the clinical epidemiological characteristics of psoriasis vulgaris in a Dermatology Hospital and summarize the clinical epidemiological characteristics of psoriasis vulgaris in this area, so as to provide a basis for epidemiological study, prevention and treatment of psoriasis.
Three, materials and methods
The use of a skin disease hospital information system (HTS) in psoriasis vulgaris database, clinical epidemiological survey on 4523 patients. The contents of the survey include: gender, age, age of onset, course of disease, the affected area, lesion morphology, disease stage, psoriasis area and severity index (PASI), the incidence of the season, predisposing factors, family history of early and late onset, and joint symptoms. The data were analyzed by using SPSS17.0 software, draw relevant conclusions.
Four, the result
1, the proportion of men and women in psoriasis vulgaris was 1.43:1 (2662:1861).
2, first onset age from birth to 8 days to 85 years, average 26.99 + 13.74 years; the average male patients with first onset age was 27.53 + 12.69 years old, the average female patients with first onset age was 26.23 + 15.10 years old, male female first onset age later than the age of first onset (P0.05). The peak period of male first onset age in 20-30 years, the peak period of female first onset age in 10-20 years.
3, the majority of patients with early onset psoriasis were 83.53% (3778/4523), and 16.47% (745/4523) with late onset psoriasis.
4, the duration of disease ranged from 3 days to 60 years, with an average of 7.43 + 8.65 years, with a median of 4.08 years. The average duration of male patients was 7.37 + 8.56 years, with a median of 4.12 years. The average duration of the female patients was 7.51 years, 8.78 years, with a median of 7.51 years, with no significant difference (P0.05).
5, the skin involvement was more common in many parts of the patients. The most common part was the lower extremities, accounting for 89.74% (4059/4523), followed by the upper limbs, accounting for 86.09% (3894/4523). The trunk accounted for 83.44% (3774/4523), and the head accounted for 80.34% (3634/4523). The least affected part was mucosa, accounting for only 1.06% (48/4523).
6, 47.29% (2139/4523) was the most common form of skin lesions, followed by dripping 23.13% (1406/4523), coin like 22.48% (1017/4523), and the most unusual band was 0.22% (10/4523).
7, the most common patients in the stable period were 57.42% (2597/4523), 21.98% (994/4523) and 21.93% (992/4523) in the progressive period.
8, the average PASI score of all the patients was 6.33 + 5.62: the average PASI score of the early onset patients was 6.13 + 5.21, the average PASI score of the late-onset patients was 7.33 + 7.21, and there was a significant difference between them (P0.05):
9, patients with family history account for 24.23% (1093/4523), 26.18% (989/3778), early onset patients have family history, and 13.83% (103/745) late-onset patients have family history, and there is significant difference between them (P0.05).
10, the most common inducing factors were biological factors 43.99% (494/1123) and seasonal factors 31.43% (353/1123). The onset or aggravation season was 47.88% (169/353) in winter, 47.31% (167/353) in spring, followed by fall 21.25% (75/353), and the lowest in summer was 12.18% (43/353).
11,14.87% (673/4523) patients have joint symptoms, and 5.81% (112/1928) patients are diagnosed with psoriasis with arthritis.
Five. Conclusion
Patients with psoriasis vulgaris in men than women; for the first time there is a gender difference in age of onset, male patients with early onset later than women; significantly more than patients with late onset psoriasis patients; most of the longer course of disease; the affected area with the most common lesions of limbs; morphology to bankuaizhuang guttata are; patients with stable disease in the majority; mild to moderate (PASI10); role of genetic factors in the late onset of early onset in the pathogenesis of important predisposing factors in patients with psoriasis; biological factors and seasonal factors are most common, the majority of patients with serious illness in winter and spring in summer and autumn, reduce; joint symptoms of patients with psoriasis vulgaris with psoriatic arthritis need to be alert to possible.

【学位授予单位】：山东大学
【学位级别】：硕士
【学位授予年份】：2011
【分类号】：R758.63

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