银屑病合并症的回顾性分析

发布时间：2018-03-17 19:29

本文选题：银屑病　切入点：合并症　出处：《浙江大学》2011年硕士论文　论文类型：学位论文

【摘要】：研究背景：银屑病是一类慢性的炎症性疾病,典型表现为身体多处皮肤表面的鳞屑样红斑。在欧洲和美国,其发病率接近2%,而在其他地区相对较少。1984年我国流行病学调查发现其人群患病率约0.123%,2008年我国6省流行病学调查发现其患病率为0.41%,较20年前有明显上升。我国人群银屑病患病率虽然低于欧美国家,但是,由于我国人口基数较大,因此,我国银屑病患者绝对数较大,而且发病的上升趋势非常明显。虽然传统的概念将银屑病作为一种皮肤疾病来认识,但是越来越多的医学文献更支持银屑病是一种多系统的疾病。其所表现的症状和体征往往比预期更复杂,更像是一种复杂的临床综合征。通过研究银屑病和其他疾病的相关性阐明银屑病广泛的病理生理机制越来越被人们所热衷,应用多学科交叉的研究方法,阐明其各个器官合并症的机制,从而改善银屑病的治疗效果以及大大改善银屑病患者的长期预后。目的：探讨银屑病合并症如代谢综合征、肥胖、心血管疾病、银屑病性关节炎、自身免疫性疾病、恶性肿瘤等的发生率及相关性分析。方法：选择2008年12月1日至2011年2月28日于浙江大学医学院附属第二医院皮肤科住院患者180例,收集患者性别、年龄、发病年龄及高血压与糖尿病疾病史等相关因素,并对其进行分析；并且检测所有人员体重指数(Body mass index,BMI)、血常规、总胆固醇(TCH)、甘油三酯(TG)、高密度脂蛋白胆固醇(High-density lipoprotein cholesterol, HDL-C)、低密度脂蛋白胆固醇(Low-density lipoprotein cholesterol, HDL-C)、血尿素氮、血肌酐、肿瘤标记物、免疫球蛋白、补体等指标,通过比较上述指标的差异,分析合并症的发生率及聚集性与其间的相关性分析。结果：(1)女性银屑病患者多在40岁以前发病。(2)男女银屑病患者患高血压没有显著性差异(P0.05)。(3)男女银屑病患者患糖尿病没有显著性差异(P0.05)。(4)男女银屑病患者患肥胖症没有显著性差异(P0.05)。(5)银屑病Ⅰ型及Ⅱ型患者患肥胖症没有显著性差异(P0.05)。(6)Ⅱ型银屑病患者高血压发病率显著增加(P0.01)。(7)银屑病患者糖尿病患病率远高于一般人群。(8)Ⅰ型与Ⅱ型患者总胆固醇的升高没有显著性差异(P0.05)、甘油三酯的升高没有显著性差异(P0.05)、高密度脂蛋白胆固醇(HDL-C)的降低没有显著性差异(P0.05)、低密度脂蛋白胆固醇(HDL-C)的升高没有显著性差异(P0.05)。(9)肿瘤标记物中,SCC指标在Ⅰ型与Ⅱ型患者中具有显著性差异(P0.05)。其余指标如CEA、AFP、CA199、CA125、CA242、CA211、CA724、NSE、pSCG、CA153、PSA、f-PSA、TPSA、f-TPSA均没有显著性差异(P0.05)。结论：银屑病不仅仅是一种皮肤疾病,更是一种可并发其他多系统损害的慢性炎症性疾病。临床医师在治疗时,需同时评估多系统的情况。全面的体格检查对早期合并症症状和体征的监测非常重要,必要时寻找多学科的密切合作,如皮肤科医师、心血管疾病医师以及内分泌科医师等。更重要的是临床上应关注患者的饮食习惯及生活方式。
[Abstract]:Background: psoriasis is a chronic inflammatory disease, typically lepidic erythema multiple skin surface. In Europe and the United States, the incidence rate is close to 2%, and in other areas of relatively few.1984 years our survey found that the prevalence of epidemiological survey of about 0.123%, 6 province epidemiology in China in 2008 the prevalence rate was 0.41%, have increased significantly compared to 20 years ago. China's population prevalence rate of psoriasis was lower than the European and American countries, however, due to China's large population base, therefore, the absolute number of psoriasis patients in China is large, and rising incidence trend is very obvious.
Although the traditional concept of psoriasis as a skin disease to understand, but more and more medical literature support psoriasis is a multisystem disease. The symptoms and signs are often more complicated than expected, more like a complex clinical syndrome. To clarify the pathophysiology of psoriasis and widely by the research of the relationship of psoriasis and other diseases are more enthusiastic people, research methods of interdisciplinary, to clarify the mechanism of each organ complications, so as to improve the treatment of psoriasis and greatly improve the long-term prognosis of patients with psoriasis.
Objective: To explore the incidence and correlation of psoriasis complications, such as metabolic syndrome, obesity, cardiovascular disease, psoriatic arthritis, autoimmune diseases and malignant tumors.
Methods: from December 1, 2008 to February 28, 2011 in the Second Affiliated Hospital of Medical College of Zhejiang University, Department of Dermatology, 180 patients were collected, gender, age, age of onset and related factors of hypertension and diabetes disease history, and carries on the analysis; and the detection of all the staff of body mass index (Body mass index, BMI), blood routine, total cholesterol (TCH), triglyceride (TG), high density lipoprotein cholesterol (High-density lipoprotein, cholesterol, HDL-C), low density lipoprotein cholesterol (Low-density lipoprotein, cholesterol, HDL-C), blood urea nitrogen, serum creatinine, tumor marker, immunoglobulin, complement and other indicators, by comparing the indicators, analysis of relationship between occurrence rate and the aggregation and analysis of complications.
Results: (1) female patients with psoriasis in the onset before the age of 40. (2) and psoriasis patients with hypertension had no significant difference (P0.05). (3) there is no significant difference between male and female patients with psoriasis with diabetes mellitus (P0.05). (4) and psoriasis patients had no significant difference (P0.05) (obesity. 5) type I and type II psoriasis patients suffering from obesity had no significant difference (P0.05). (6) significantly increased the incidence of hypertension in patients with psoriasis type II (P0.01). (7) the prevalence rate is much higher than the general population of diabetes mellitus in patients with psoriasis. (8) the type I and total cholesterol were not significantly increased the difference (P0.05), there was no significant difference in triglyceride (P0.05), high density lipoprotein cholesterol (HDL-C) there is no significant difference between the reduced (P0.05), low density lipoprotein cholesterol (HDL-C) there is no significant difference between the high rise (P0.05). (9) tumor markers, the SCC index in the There was a significant difference between type I and type II patients (P0.05). There were no significant differences in other indicators such as CEA, AFP, CA199, CA125, CA242, CA211, CA724, NSE, pSCG, CA153, PSA, l, t, and H.
Conclusion: psoriasis is not only a kind of skin disease, is a kind of complicated with many other system damage in chronic inflammatory disease. Clinicians in the treatment, and evaluation system. Monitoring comprehensive physical examination on early symptoms and signs of complications are very important and necessary for close cooperation, multi discipline such as dermatologists, cardiovascular disease physicians and Department of Endocrinology physicians. The more important is the clinical patients should pay attention to diet and lifestyle.

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

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