本文選題：尋常型銀屑病　切入點(diǎn)：流行病學(xué)　出處：《山東大學(xué)》2011年碩士論文　論文類型：學(xué)位論文

【摘要】：一、研究背景 銀屑病是由遺傳和環(huán)境等多種因素相互作用引起的慢性炎癥性皮膚病,具有易復(fù)發(fā)、病程長的特點(diǎn),嚴(yán)重影響患者的身心健康。銀屑病的發(fā)病率在世界各地有明顯不同,與種族、地理位置、環(huán)境等因素有關(guān)。根據(jù)臨床表現(xiàn)銀屑病可分為尋常型、膿皰型、紅皮病型及關(guān)節(jié)病型,其中尋常型銀屑病最常見。根據(jù)發(fā)病年齡也可將銀屑病分為兩型,早發(fā)型(Ⅰ型)患者在40歲前發(fā)病,晚發(fā)型(Ⅱ型)患者在40歲后發(fā)病。1984年中國調(diào)查發(fā)現(xiàn)銀屑病的患病率為0.123%。2010年中國六個(gè)不同省市的銀屑病流行病學(xué)調(diào)查結(jié)果顯示,目前銀屑病的患病率已經(jīng)增長為0.47%。不同地區(qū)、不同人群中銀屑病的臨床流行病學(xué)特征可能不盡相同,本地區(qū)尚缺乏銀屑病患者的流行病學(xué)資料。為了給大規(guī)模的流行病學(xué)調(diào)查提供參考數(shù)據(jù),需要對現(xiàn)階段就診銀屑病患者的流行病學(xué)特征進(jìn)行了解。 二、研究目的 通過對某皮膚病醫(yī)院門診就診尋常型銀屑病患者進(jìn)行調(diào)查分析,總結(jié)描述本地區(qū)尋常型銀屑病患者的臨床流行病學(xué)特征,為銀屑病的流行病學(xué)研究、預(yù)防和治療提供對策依據(jù)。 三、材料與方法 利用某皮膚病醫(yī)院信息系統(tǒng)(HTS)中的門診尋常型銀屑病患者數(shù)據(jù)庫資料,對4523例患者進(jìn)行臨床流行病學(xué)調(diào)查。調(diào)查內(nèi)容包括：性別、年齡、首次發(fā)病年齡、病程、受累部位、皮損形態(tài)、病情分期、銀屑病面積和嚴(yán)重程序指數(shù)(PASI)、發(fā)病季節(jié)、誘發(fā)因素、早發(fā)型和晚發(fā)型、家族史、關(guān)節(jié)癥狀等。利用SPSS17.0軟件對數(shù)據(jù)進(jìn)行統(tǒng)計(jì)學(xué)分析,得出相關(guān)結(jié)論。 四、結(jié)果 1、尋常型銀屑病患者中男女比例為1.43：1(2662：1861)； 2、首次發(fā)病年齡從出生8天到85歲,平均26.99±13.74歲；男性患者的平均首次發(fā)病年齡為27.53±12.69歲,女性患者的平均首次發(fā)病年齡為26.23±15.10歲,男性首次發(fā)病年齡晚于女性首次發(fā)病年齡(P0.05)。男性首次發(fā)病年齡的高峰段在20-30歲之間,女性首次發(fā)病年齡的高峰段在10-20歲之間。 3、早發(fā)型銀屑病患者占大多數(shù),為83.53%(3778/4523),晚發(fā)型銀屑病患者占16.47%(745/4523)； 4、病程從3天到60年,平均7.43±8.65年,中位數(shù)為4.08年；男性患者的平均病程為7.37±8.56年,中位數(shù)為4.12年；女性患者的平均病程為7.51±8.78年,中位數(shù)為4.07年,無顯著性差異(P0.05) 5、患者多部位皮膚受累較常見。最多見的是下肢,占89.74%(4059/4523)；其次是上肢,占86.09%(3894/4523)。軀干占83.44%(3774/4523),頭部占80.34%(3634/4523)。受累最少的部位是黏膜,僅占1.06%(48/4523)。 6、皮損形態(tài)以斑塊狀47.29%(2139/4523)最為常見,其次是點(diǎn)滴狀23.13%(1406/4523)、錢幣狀22.48%(1017/4523)；最少見的是帶狀0.22%(10/4523)。 7、穩(wěn)定期患者最多見,占57.42%(2597/4523)；進(jìn)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評分為6.33±5.62：早發(fā)型患者的平均PASI評分為6.13±5.21,晚發(fā)型患者的平均PASI評分為7.33±7.21,兩者有顯著性差異(P0.05)： 9、有家族史的患者占24.23%(1093/4523)；26.18%(989/3778)早發(fā)型患者有家族史,13.83%(103/745)晚發(fā)型患者有家族史,兩者有顯著性差異(P0.05)； 10、最常見的誘發(fā)因素為生物因素43.99%(494/1123)和季節(jié)因素31.43%(353/1123)；發(fā)病或加重季節(jié)以冬季47.88%(169/353)、春季47.31%(167/353)為主,其次是秋季21.25%(75/353),夏季最少12.18%(43/353)； 11、14.87%(673/4523)患者有關(guān)節(jié)癥狀,5.81%(112/1928)患者確診合并關(guān)節(jié)病型銀屑病。 五、結(jié)論 尋常型銀屑病患者中男性多于女性；首次發(fā)病年齡存在性別差異,男性晚于女性；早發(fā)型患者顯著多于晚發(fā)型患者；多數(shù)銀屑病患者病程較長；受累部位以四肢最常見；皮損形態(tài)以斑塊狀、點(diǎn)滴狀居多；穩(wěn)定期患者占多數(shù)；病情以輕中度為主(PASI10)；遺傳因素在早發(fā)型患者發(fā)病中的作用較晚發(fā)型重要；銀屑病患者的誘發(fā)因素以生物因素和季節(jié)因素最常見,多數(shù)患者冬春季病情較重,夏秋季減輕；有關(guān)節(jié)癥狀的尋常型銀屑病患者需要警惕合并關(guān)節(jié)病型銀屑病的可能。
[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.

【學(xué)位授予單位】：山東大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2011
【分類號(hào)】：R758.63

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