汉族人儿童寻常型银屑病和成人寻常型银屑病临床特征分析

发布时间：2018-04-30 03:21

本文选题：银屑病 + 寻常型　；参考：《安徽医科大学》2011年硕士论文

【摘要】：研究背景银屑病是一种常见的以红斑,鳞屑为主要表现的慢性反复发作炎症性皮肤病,本病在世界各地和不同种族人群中的总患病率有所差异,报道在欧洲人群中的患病率为2%～3%,亚洲患病率较低,中国汉族人群中患病率约为0.123%,目前我国有银屑病患者约400万,多为青壮年。银屑病可分为若干临床类型,经典分型中,以寻常型银屑病(PV)最为多见,占患者总数90%以上。银屑病确切发病机制尚不完全清楚,目前认为该病是一种由遗传和环境等多种因素共同作用的复杂疾病。由于遗传异质性,银屑病的临床表型多样化,国外较多研究显示发病年龄早晚和家族史之间有着密切联系,而且新近不同地区的多个人群研究发现体重指数(BMI)和银屑病也有着密切的关系。和国外研究资料相比,国内对寻常型银屑病临床特征研究仍较少,因此,进一步探索汉族人PV的临床特征,不仅有助于其基因型表型的深入研究,而且对正确理解和认识银屑病发病机制,提高对银屑病诊治大有帮助。目的分析中国汉族人儿童PV和成人PV在初始发病性别、家族史、同形反应、发病部位、发病季节和严重程度上的差别以及寻常型银屑病严重程度和同形反应间关联性,以探讨儿童PV和成人PV的遗传学背景。方法在皮肤科门诊采用问卷调查形式收集2015例PV患者完整流行病学调查问卷,其中年龄小于18岁儿童PV患者529例,年龄18岁及其以上成人PV患者1486例,用SPSS10.0软件(美国伊利诺斯州,SPSS公司)对资料进行统计分析。结果1.成人PV患者中男性患病比例较女性高(P㩳0.01)。2.儿童PV患者家族史阳性率较成人PV家族史阳性率高(P㩳0.01),更容易累及面部(P㩳0.01)、颈部(P㩳0.05)、躯干(P㩳0.05)和手(P㩳0.01)。3.PV严重程度和同形反应间存在着关联性(P㩳0.01,r=0.074)。4.家族史阳性患者总体发病年龄较家族史阴性患者发病年龄提前(P㩳0.05)。结论1.儿童PV较成人PV家族史阳性率高,和遗传关系更大。2.儿童PV较成人PV首次患病更容易累及面部、颈部、躯干和手。3.PV家族史阳性患者较家族史阴性患者总体初始发病年龄提前。4.PV严重程度和同形反应间存在着关联性,同形反应阳性可作为病情活动参考指标。5.中国汉族人儿童PV和成人PV临床特征存在差异,通过年龄分层研究中国汉族人儿童PV和成人PV具有可行性。
[Abstract]:Background psoriasis is a common chronic recurrent inflammatory dermatosis characterized by erythema and scales. The prevalence of psoriasis in Europe is about 2%, and that in Asia is low. The prevalence of psoriasis in Chinese Han population is about 0. 123%. At present, there are about 4 million psoriasis patients in China, most of them are young and middle-aged. Psoriasis can be divided into several clinical types. PVV is the most common type of psoriasis vulgaris, accounting for more than 90% of the patients. The exact pathogenesis of psoriasis is not completely clear, and it is considered to be a complex disease which is affected by many factors, such as heredity and environment. Due to genetic heterogeneity and the diversity of clinical phenotypes of psoriasis, many foreign studies have shown that there is a close relationship between onset age and family history. Recent population studies in different regions have also found a close relationship between body mass index (BMI) and psoriasis. Compared with foreign research data, there are few studies on clinical characteristics of psoriasis vulgaris in China. Therefore, further exploring the clinical characteristics of PV in Han nationality is not only helpful to further study its genotype phenotype. It is helpful to understand and understand the pathogenesis of psoriasis and to improve the diagnosis and treatment of psoriasis. Objective to analyze the relationship between the onset sex, family history, homotypic reaction, site, season and severity of PV in Chinese Han nationality children and adults, as well as the relationship between the severity of psoriasis vulgaris and the isomorphic response. To explore the genetic background of PV in children and adults. Methods A complete epidemiological questionnaire was collected from 2015 patients with PV in dermatological outpatient department, including 529 cases of PV in children under 18 years old and 1486 cases of PV in adults aged 18 years or over. The data were analyzed by SPSS10.0 software. Result 1. The proportion of male patients with PV was higher than that of female patients. The positive rate of family history in children with PV was higher than that in adults, and it was more likely to involve P0. 01, P0. 05, P0. 05, P0. 05) and P0. 01. 3. There was a correlation between the severity of PV and the homotypic reaction (P0. 01 rr0. 074. 4) in children with PV, and P0. 05, P0. 05, P0. 05, P0. 05 in the trunk, and P0. 01. 3. The severity of PV was associated with homotypic reaction. The onset age of patients with positive family history was higher than that of patients with negative family history. Conclusion 1. The positive rate of PV in children was higher than that in adults, and the genetic relationship was higher. 2. 2. Children with PV were more likely to be involved in the face, neck, trunk and hands than adults. 3. There was a correlation between the severity of PV and the homotypic reaction in children with PV, who had positive family history and had earlier onset age than those with negative family history. Isomorphic positive reaction can be used as a reference index of disease activity. The clinical characteristics of PV in Chinese Han nationality children were different from those in adults. It was feasible to study PV in children and adults of Han nationality by age stratification.
【学位授予单位】：安徽医科大学
【学位级别】：硕士
【学位授予年份】：2011
【分类号】：R758.63

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