重型痤疮临床特征分析

发布时间：2018-03-05 09:26

本文选题：重型痤疮　切入点：青春期　出处：《中国全科医学》2014年23期 　论文类型：期刊论文

【摘要】：目的分析不同性别、年龄重型痤疮患者的临床特征,为重型痤疮寻找更有针对性的治疗方法提供依据。方法 2009—2011年采用抽样调查法,从我国24个城市的35家三级甲等医院皮肤科门诊选取1 944例重型痤疮患者。采用《寻常痤疮遗传流行病学调查问卷》由2位经验丰富的皮肤科临床医师评估患者皮损类型、数量及分布部位并指导填写调查问卷。结果 1 944例重型痤疮患者中,男1 000例,女944例;青春期痤疮1 433例,其中男842例(58.8%)、女591例(41.2%);成人痤疮511例,其中男158例(30.9%)、女353例(69.1%)。不同类型痤疮在男、女性患者中的分布情况比较,差异有统计学意义(χ2=116.60,P0.001)。成人痤疮包括青春期发病持续到25岁以后的持续性痤疮377例(73.5%),25岁以后发病的迟发型痤疮134例(26.5%)。353例女性成人痤疮患者中,238例(67.4%)为持续性痤疮,115例(32.6%)为迟发型痤疮;158例男性成人痤疮中,139例(88.0%)为持续性痤疮,19例(12.0%)为迟发型痤疮。男、女性成人痤疮均以持续性痤疮为主,但女性迟发型痤疮发生率高于男性,差异有统计学意义〔χ2=23.36,OR=2.71,95%CI(1.73,4.23),P0.001〕。716例(36.8%)患者有痤疮家族史,其中男349例,女367例;青春期痤疮569例(79.5%),持续性痤疮130例(18.1%),迟发型痤疮17例(2.4%)。有痤疮家族史的男、女性患者中,男性青春期痤疮发生率高于女性,而女性持续性痤疮、迟发型痤疮发生率高于男性(P0.05)。女性重型痤疮患者中,从皮损数量来看:青春期痤疮丘疹/脓疱的数量较持续性痤疮(Z=2.39,P=0.017)多,与迟发型痤疮(Z=1.25,P=0.210)接近;青春期痤疮(Z=-3.87,P0.001)及持续性痤疮(Z=-3.68,P0.001)萎缩性瘢痕的数量较迟发型痤疮多;粉刺(χ2=2.48,P=0.290)、结节/囊肿(χ2=1.94,P=0.379)及增生性瘢痕(χ2=4.40,P=0.106)的数量在不同类型痤疮间差异无统计学意义。从皮损分布部位来看:与青春期痤疮相比,持续性痤疮额头、面颊出现丘疹/脓疱的发生率较低,背部出现结节/囊肿,下颌出现萎缩性瘢痕的发生率较高,差异有统计学意义(P0.05);迟发型痤疮鼻部出现萎缩性瘢痕的发生率较青春期痤疮高(P0.05)。男性重型痤疮患者中,从皮损数量来看:粉刺(χ2=0.07,P=0.966)、丘疹/脓疱(χ2=1.02,P=0.600)、结节/囊肿(χ2=0.31,P=0.857)、增生性瘢痕(χ2=3.37,P=0.186)及萎缩性瘢痕(χ2=5.03,P=0.081)的数量在不同类型痤疮间差异均无统计学意义。从皮损分布部位来看:青春期痤疮面颊遗留萎缩性瘢痕的发生率为48.0%(404/842),高于迟发型痤疮的36.8%(7/19),差异有统计学意义〔χ2=5.00,OR=1.60,95%CI(1.06,2.41),P=0.025〕。结论重型痤疮中青春期痤疮发生率最高,成人痤疮以青春期后的持续性痤疮为主,女性出现成人痤疮,特别是迟发型痤疮的风险较男性高。痤疮家族史对青春期痤疮及女性成人痤疮的影响较大。
[Abstract]:Objective to analyze the clinical features of different gender, age of severe acne patients, provide the basis for targeted therapies for severe acne. Looking for a better method from 2009 to 2011 by sampling survey method, from the 24 city in China 35 three level of first-class hospital outpatient department of Dermatology from 1944 patients with heavy acne acne vulgaris. The "genetic epidemiology the questionnaire > type lesions of patients with by 2 experienced clinicians to assess the quantity and distribution of the Department of Dermatology, and to guide the site to fill in the questionnaire. The results of 1944 cases of severe acne patients, male 1000 cases, female 944 cases; adolescent acne 1433 cases, 842 cases were male (58.8%), 591 cases of female adults (41.2%); 511 cases of acne, 158 cases were male (30.9%), 353 cases were female (69.1%). Different types of acne in male, compared the distribution of female patients, the difference was statistically significant (2=116.60, P0.001) including adolescent adult acne. The incidence of persistent acne until 25 years later in 377 cases (73.5%), after 25 years the incidence of late-onset acne in 134 cases (26.5%).353 cases of female adult acne patients, 238 cases (67.4%) for persistent acne, 115 cases (32.6%) were late onset acne; 158 cases of male adult acne. 139 cases (88%) for persistent acne, 19 cases (12%) were late onset acne. Male and female adult acne were dominated by persistent acne, but female delayed acne was higher than that in males, the difference was statistically significant, X 2=23.36, OR=2.71,95%CI (1.73,4.23), P0.001.716 (36.8%) cases of patients a family history of acne, male 349 cases, female 367 cases; 569 cases of acne vulgaris (79.5%), persistent acne (18.1%), 130 cases of late-onset acne in 17 cases (2.4%). There is a family history of acne of male and female patients, male adolescent acne incidence was higher than female, while female persistent acne the high incidence of late-onset acne. In the male (P0.05). Female severe acne lesions, from the number of adolescent acne pimples / pustules over the number of persistent acne (Z=2.39, P=0.017), and late onset acne (Z=1.25, P=0.210) approach; adolescent acne (Z=-3.87, P0.001) and persistent acne (Z=-3.68, P0.001) the number of atrophy scar than late-onset acne acne; (x 2=2.48, P=0.290), nodule or cyst (x 2=1.94, P=0.379) and hypertrophic scar (2=4.40, P=0.106) the number of differences in different types of acne have no statistical significance. From the skin loss distribution location: compared with adolescent acne, persistent acne forehead the cheek, papules pustules / lower incidence of back nodule or cyst, mandibular appeared atrophic scar occurred at a higher rate, the difference was statistically significant (P0.05); late onset acne nose appeared atrophic scar is high incidence of adolescent acne (P0.05) Male. Severe acne, acne lesions from number: (x 2=0.07, P=0.966), papules and pustules (2=1.02, P=0.600), nodule or cyst (x 2=0.31, P=0.857), hypertrophic scar (2=3.37, P=0.186) and atrophic scar (x 2=5.03, P=0.081) the difference in the number of different types of acne had no statistical significance. From the distribution of lesions location: left cheek adolescent acne atrophic scar occurred in 48% (404/842), higher than late onset acne (36.8% 7/19), the difference was statistically significant, X 2=5.00, OR=1.60,95% CI (1.06,2.41), P=0.025. The highest rate of adolescent acne conclusion severe acne, adult acne with persistent acne after puberty, female adult acne, especially the risk of late-onset acne is higher than male. Influence of family history on adolescent acne acne and acne in female adults.

【作者单位】：昆明医科大学第一附属医院皮肤性病科/医疗美容科云南省皮肤病研究所;昆明医科大学基础医学院生理学教研室;昆明医科大学科技处;
【基金】：国家自然科学基金资助项目(81060123,81360234) 云南省应用基础研究计划项目(2011FA028,2012FB004)
【分类号】：R758.733

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