特应性皮炎不同性别、年龄和发病部位聚集效应的临床研究
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摘要
目的探讨特应性皮炎(atopic dermatitis,AD)的发病情况以及不同性别、发病年龄和部位的聚集效应。方法收集2014年1月至2015年12月在中国13个城市31所三级医院皮肤科就诊的湿疹患者,回顾性分析5 953例湿疹患者的资料,其中AD患者964例。通过对性别、年龄和部位的AD发病情况进行统计处理,分析和总结AD发病的聚集效应。结果 5 953例湿疹患者中,AD共964例,占16. 19%。男性与女性患者间AD比例差异无统计学意义(P> 0. 05);男性与女性患者间年龄因素未见明显影响(P> 0. 05)。婴儿期(<3岁)和儿童期(3岁≤年龄<12岁)比例均高于其他年龄组(P <0. 05),差异有统计学意义。婴幼儿(<3岁组) 71例患者中70例为头面眼睑,而老年(≥61岁组)以四肢伸侧为主。低年龄(<24岁)患者发病部位为头面眼睑的占比高于其他年龄组; 24≤年龄<41岁患者足-四肢伸侧、躯干-手-四肢伸侧、项颈-躯干的占比高于其他年龄组; 24岁以上患者四肢伸侧占比高于其他年龄组。差异均有统计学意义(P <0. 001)。964例患者中,发病部位为四肢伸侧最多(50. 10%),其次为头面眼睑(41. 08%);前10位的发病部位共有583例患者,占60. 48%;发病部位个数平均为(2. 07±1. 12)个,1个和2个发病部位分别占35. 06%和37. 66%。1个发病部位患者以头面眼睑和四肢伸侧为主(共占71. 01%),双部位发病患者以足-四肢伸侧、头面眼睑-项颈、躯干-四肢伸侧为主。女性发病部位为足-四肢伸侧和项颈-躯干的比例高于男性(P<0. 001),男性躯干-四肢伸侧和肘窝膝窝-项颈的比例高于女性(P <0. 001)。低年龄组(<24岁)患者发病部位为头面眼睑的占比高于其他年龄组(P <0. 001),24岁≤年龄<41岁患者足-四肢伸侧、躯干-手-四肢伸侧、项颈-躯干的占比高于其他年龄组(P <0. 001),24岁以上年龄组四肢伸侧占比高于其他年龄组(P <0. 001)。结论性别对于不同年龄患者AD发病情况并无显著影响;年龄具有明显"聚集效应",好发于婴儿期(<3岁)和儿童期(3岁≤年龄<12岁);发病部位具有一定"聚集效应",尤其是不同年龄患者的发病部位存在明显的差异。
Objective To investigate the incidence of atopic dermatitis( AD) and the aggregation effect in patients with different sex,age groups and skin regions. Methods Clinical data of 5 953 patients with eczema( 964 AD patients) were collected and retrospectively analyzed from 31 dermatology clinics in 13 cities from January 2014 to December 2015. The prevalence of AD in different sex,age groups and skin regions was summarized and the aggregation effect of AD was analyzed. Results Among the 5 953 patients with eczema,964( 16. 19%) were AD. There was no significant difference in the proportion of AD between male and female patients( P > 0. 05); there was no significant difference in age between male and female patients( P > 0. 05). The occurrence rate in infants( < 3 years) and children( 3 years ≤age < 12 years years) was significantly higher than those in other age groups( P < 0. 05).Of 71 infants( < 3 years group),70 were presented in scalp,face and eyelids,while the elderly( ≥61 years group) were mainly presented in the extremities extension. The occurrence rate in scalp,face and eyelids was higher in patients of low age( < 24 years)than that in other age groups; the occurrence rate in feet-extremities extension,trunk-hands-extremities extension and neck-trunk in patients aged 24 years≤age < 41 years was higher than that in other age groups; the occurrence rate in extremities extension in patients over 24 years old was higher than that in other age groups( all P < 0. 001). Among 964 AD patients,the most common skin region was extremities extension( 50. 10%),followed by scalp,face and eyelid( 41. 08%). Totally 583 patients( 60. 48%) were presented in the first 10 skin regions,and the average number of lesion sites was( 2. 07 ± 1. 12),one and two skin regions accounted for 35. 06% and37. 66% of all AD patients,respectively. Patients with one skin region were mainly presented in scalp,face,eyelid and extremities extension( 71. 01%),while patients with two skin regions were mainly presented in feet-extremities extension,scalp,face,eyelid-neck,and trunk-extremities extension. The occurrence rate in feet-extremities extension and neck-trunk was higher in females than that in males( P < 0. 001),while the occurrence rate in trunk-extremities extension and cubital and popliteal fossae was higher in males than that in females( P < 0. 001). The occurrence rate in scalp,face and eyelid was higher in low age group( 24 years) than that in other age groups( P < 0. 001). The occurrence rate in feet-extremities extension,trunk-hands-extremities extension and neck-trunk in patients aged 24 years≤age < 41 years was higher than that in other age groups( P < 0. 001),and the occurrence rate in extremities extension in patients over 24 years old was higher than that in other age groups( P < 0. 001). Conclusion Sex has no significant influence on the incidence of AD in patients at different age groups. There is a significant "aggregation effect"in different age groups,especially in infancy( < 3 years) and childhood( 3 years ≤ age < 12 years). The skin regions of AD shows some "aggregation effect",especially in patients at different age groups.
Objective To investigate the incidence of atopic dermatitis( AD) and the aggregation effect in patients with different sex,age groups and skin regions. Methods Clinical data of 5 953 patients with eczema( 964 AD patients) were collected and retrospectively analyzed from 31 dermatology clinics in 13 cities from January 2014 to December 2015. The prevalence of AD in different sex,age groups and skin regions was summarized and the aggregation effect of AD was analyzed. Results Among the 5 953 patients with eczema,964( 16. 19%) were AD. There was no significant difference in the proportion of AD between male and female patients( P > 0. 05); there was no significant difference in age between male and female patients( P > 0. 05). The occurrence rate in infants( < 3 years) and children( 3 years ≤age < 12 years years) was significantly higher than those in other age groups( P < 0. 05).Of 71 infants( < 3 years group),70 were presented in scalp,face and eyelids,while the elderly( ≥61 years group) were mainly presented in the extremities extension. The occurrence rate in scalp,face and eyelids was higher in patients of low age( < 24 years)than that in other age groups; the occurrence rate in feet-extremities extension,trunk-hands-extremities extension and neck-trunk in patients aged 24 years≤age < 41 years was higher than that in other age groups; the occurrence rate in extremities extension in patients over 24 years old was higher than that in other age groups( all P < 0. 001). Among 964 AD patients,the most common skin region was extremities extension( 50. 10%),followed by scalp,face and eyelid( 41. 08%). Totally 583 patients( 60. 48%) were presented in the first 10 skin regions,and the average number of lesion sites was( 2. 07 ± 1. 12),one and two skin regions accounted for 35. 06% and37. 66% of all AD patients,respectively. Patients with one skin region were mainly presented in scalp,face,eyelid and extremities extension( 71. 01%),while patients with two skin regions were mainly presented in feet-extremities extension,scalp,face,eyelid-neck,and trunk-extremities extension. The occurrence rate in feet-extremities extension and neck-trunk was higher in females than that in males( P < 0. 001),while the occurrence rate in trunk-extremities extension and cubital and popliteal fossae was higher in males than that in females( P < 0. 001). The occurrence rate in scalp,face and eyelid was higher in low age group( 24 years) than that in other age groups( P < 0. 001). The occurrence rate in feet-extremities extension,trunk-hands-extremities extension and neck-trunk in patients aged 24 years≤age < 41 years was higher than that in other age groups( P < 0. 001),and the occurrence rate in extremities extension in patients over 24 years old was higher than that in other age groups( P < 0. 001). Conclusion Sex has no significant influence on the incidence of AD in patients at different age groups. There is a significant "aggregation effect"in different age groups,especially in infancy( < 3 years) and childhood( 3 years ≤ age < 12 years). The skin regions of AD shows some "aggregation effect",especially in patients at different age groups.
引文
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[3] Wollenberg A,Oranje A,Deleuran M,et al. ETFAD/EADV Eczema task force 2015 position paper on diagnosis and treatment of atopic dermatitis in adult and paediatric patients[J]. J Eur Acad Dermatol Venereol,2016,30(5):729-747.
[4] Katayama I,Aihara M,Ohya Y,et al. Japanese guidelines for atopic dermatitis 2017[J]. Allergol Int,2017,66(2):230-247.
[5]中华医学会皮肤性病学分会免疫学组,特应性皮炎协作研究中心.中国特应性皮炎诊疗指南(2014版)[J].中华皮肤科杂志,2014,47(7):511-514.
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[7] Malik K,Heitmiller K D,Czarnowicki T. An update on the pathophysiology of atopic dermatitis[J]. Dermatol Clin,2017,35(3):317-326.
[8] Dharmage S C,Lowe A J,Matheson M C,et al. Atopic dermatitis and the atopic march revisited[J]. Allergy,2014,69(1):17-27.
[9]李妍,徐薇,程海艳,等.白介素4、10、12、13、IFN-γ、TGF-β在不同时期特应性皮炎病人血清中的变化[J].首都医科大学学报,2017,38(5):635-639.
[10]狄正鸿,许静,侯殿东,等.小鼠SPINK5基因重组过表达腺病毒载体构建及其对特应性皮炎小鼠模型皮损疗效的研究[J].中国医科大学学报,2017,46(1):11-16.
[11]邵莉梅,叶文正,李姗姗,等.汉族人3915例特应性皮炎患者的临床特征分析[J].安徽医科大学学报,2011,46(11):1175-1178.
[12] Yew Y W,Thyssen J P,Silverberg J I. A systematic review and meta-analysis of the regional and age-related differences in atopic dermatitis clinical characteristics[J]. J Am Acad Dermatol,2019,80(2):390-401.
[2] Lifschitz C. The impact of atopic dermatitis on quality of life[J]. Ann Nutr Metab,2015,66 Suppl 1:34-40.
[3] Wollenberg A,Oranje A,Deleuran M,et al. ETFAD/EADV Eczema task force 2015 position paper on diagnosis and treatment of atopic dermatitis in adult and paediatric patients[J]. J Eur Acad Dermatol Venereol,2016,30(5):729-747.
[4] Katayama I,Aihara M,Ohya Y,et al. Japanese guidelines for atopic dermatitis 2017[J]. Allergol Int,2017,66(2):230-247.
[5]中华医学会皮肤性病学分会免疫学组,特应性皮炎协作研究中心.中国特应性皮炎诊疗指南(2014版)[J].中华皮肤科杂志,2014,47(7):511-514.
[6] Eichenfield L F,Ahluwalia J,Waldman A,et al. Current guidelines for the evaluation and management of atopic dermatitis:a comparison of the joint task force practice parameter and American academy of dermatology guidelines[J]. J Allergy Clin Immunol,2017,139(4S):S49-S57.
[7] Malik K,Heitmiller K D,Czarnowicki T. An update on the pathophysiology of atopic dermatitis[J]. Dermatol Clin,2017,35(3):317-326.
[8] Dharmage S C,Lowe A J,Matheson M C,et al. Atopic dermatitis and the atopic march revisited[J]. Allergy,2014,69(1):17-27.
[9]李妍,徐薇,程海艳,等.白介素4、10、12、13、IFN-γ、TGF-β在不同时期特应性皮炎病人血清中的变化[J].首都医科大学学报,2017,38(5):635-639.
[10]狄正鸿,许静,侯殿东,等.小鼠SPINK5基因重组过表达腺病毒载体构建及其对特应性皮炎小鼠模型皮损疗效的研究[J].中国医科大学学报,2017,46(1):11-16.
[11]邵莉梅,叶文正,李姗姗,等.汉族人3915例特应性皮炎患者的临床特征分析[J].安徽医科大学学报,2011,46(11):1175-1178.
[12] Yew Y W,Thyssen J P,Silverberg J I. A systematic review and meta-analysis of the regional and age-related differences in atopic dermatitis clinical characteristics[J]. J Am Acad Dermatol,2019,80(2):390-401.