【摘要】：目的:探討住院銀屑病某些發(fā)病規(guī)律及臨床特點,進(jìn)而提出更合理的預(yù)防及治療方案。 方法:通過收集汕頭大學(xué)醫(yī)學(xué)院第一附屬醫(yī)院皮膚科2003年1月——2010年12月間確診為銀屑病的62例住院患者的病歷進(jìn)行回顧性分析。信息包括性別、年齡、初發(fā)年齡、臨床分型、伴隨的疾病、既往的治療方法、家族史、加重及誘發(fā)因素、皮損部位。χ2和T檢驗用于數(shù)據(jù)的統(tǒng)計學(xué)分析。 結(jié)果:(1)本組資料65例銀屑病患者中男女比例為35:27,性別無顯著性差異;銀屑病患者平均初次發(fā)病年齡36.3歲,男女患者平均初次發(fā)病年齡分別為38.6歲和33.3歲;女性有兩個初次發(fā)病高峰期10-20歲和50-60歲,男性初次發(fā)病高峰期為40-50歲。(2)銀屑病首發(fā)、加重及復(fù)發(fā)以冬春為主,夏季病情減輕明顯。(3)感染或不適當(dāng)外用藥物成為銀屑病加重的突出因素。(4)銀屑病初次發(fā)病最常見的類型為尋常型銀屑病,占90.32%,膿皰型銀屑和關(guān)節(jié)病型銀屑病各占4.84%;復(fù)發(fā)病例中尋常型銀屑病占38.71 %;膿皰型銀屑病占38.71%;紅皮病型銀屑病占16.13%;關(guān)節(jié)病型銀屑病占6.45%。(5)患者皮損的初發(fā)部位以軀干和頭皮最常見。(6)患者入院前治療中外用藥主要為糖皮質(zhì)激素、維生素D3衍生物及草藥;系統(tǒng)用藥主要為抗組胺藥、糖皮質(zhì)激素、維A酸類及中藥。(7)本組資料銀屑病患者伴發(fā)系統(tǒng)疾病者占74.19%。各類感染性疾病中病毒性肝炎占3.22%,肺部感染3.22%,泌尿系感染2.22%,皰疹病毒感染3.22%。代謝性疾病中糖尿病占6.45%,糖耐量受損14.52%,高尿酸血癥6.45%,高脂血癥11.29%,低蛋白血癥48.39%。心腦血管疾病中高血壓占11.74%,冠心病8.06%,腦卒中1.61%,各類心律失常8.06%。消化系統(tǒng)疾病中脂肪肝占6.45%。(8)本組資料實驗室檢查白細(xì)胞升高者占37.10%;血紅蛋白下降占14.52%;血小板升高占22.58%.;尿常規(guī)檢查尿白細(xì)胞陽性占9.68%,尿蛋白陽性占6.45%,尿潛血陽性占4.84%;谷丙轉(zhuǎn)胺酶升高占12.90%,谷草轉(zhuǎn)胺酶升高占27.42%。 結(jié)論:(1)銀屑病的發(fā)病男女無顯著性差異;(2)季節(jié)因素對銀屑病的激發(fā)和加重具有重要影響;(3)銀屑病與感染有關(guān),銀屑病的治療應(yīng)該注意予有效的抗感染治療;(4)首次發(fā)病部位以軀干及頭皮多見;(5)銀屑病患者容易合并心血管疾病、代謝綜合征等疾病,提示銀屑病可能為一系統(tǒng)性疾病;(6)銀屑病的治療應(yīng)該規(guī)律用藥,避免外用刺激性強的藥物。
[Abstract]:Objective: to investigate the clinical characteristics and the regularity of psoriasis in hospital, and to put forward more reasonable prevention and treatment. Methods: 62 cases of psoriasis were collected from Department of Dermatology, first affiliated Hospital of Medical College of Shantou University from January 2003 to December 2010. Information included sex, age, clinical classification, associated diseases, past treatments, family history, exacerbation and predisposing factors, site of skin lesions. 蠂 2 and T tests were used for statistical analysis of data. Results: (1) in 65 cases of psoriasis, the ratio of male and female was 35: 27, there was no significant difference in sex, the average age of first onset of psoriasis was 36.3 years old, the average age of primary onset of male and female patients was 38.6 years and 33.3 years old, respectively. There were two peak periods of onset of psoriasis in females, 10-20 years old and 50-60 years old, and 40-50 years old in males. (2) the onset of psoriasis was mainly in winter and spring. (3) infection or improper use of drugs was a prominent factor in the exacerbation of psoriasis. (4) the most common type of primary onset of psoriasis was psoriasis vulgaris. The ratio was 90.32, the pustular silver crumbs and the arthrotic psoriasis were 4.84; the recurrent cases of psoriasis vulgaris were 38.71; the pustular psoriasis was 38.71; the erythrodermic psoriasis was 16.13; the arthropathic psoriasis was 6.45; (5) the primary lesions of the patients were trunk. And scalp most commonly. (6) external use of glucocorticoids in pre-hospital treatment was mainly glucocorticoid. Vitamin D3 derivatives and herbs were mainly used as antihistamines, glucocorticoids, retinoic acids and traditional Chinese medicine. (7) patients with psoriasis accompanied with systemic diseases accounted for 74.19%. Viral hepatitis accounts for 3.22 percent of all infectious diseases, lung infection 3.22, urinary tract 2.22, herpes virus 3.22. Among metabolic diseases, diabetes accounted for 6.45%, impaired glucose tolerance 14.52%, hyperuricemia 6.45%, hyperlipidemia 11.29%, hypoproteinemia 48.39%. In cardiovascular and cerebrovascular diseases, hypertension accounts for 11.74, coronary heart disease 8.06, stroke 1.61and arrhythmia 8.06. Fatty liver accounted for 6.45% of digestive system diseases. (8) the percentage of patients with elevated white blood cells was 37.10% in the laboratory, 14.52% in hemoglobin, 22.58% in platelets, 9.68% in urine routine examination, 6.45% in urine protein, and 14.52% in urine occult blood. 4.84 the aspartate transaminase increased 12.90%, the aspartate transaminase increased 27.42%. Conclusion: (1) there is no significant difference in the incidence of psoriasis between male and female; (2) seasonal factors have an important effect on the stimulation and aggravation of psoriasis; (3) psoriasis is associated with infection. The treatment of psoriasis should be paid attention to effective anti-infective treatment; (4) the first site of the disease is the trunk and scalp; (5) Psoriasis patients are prone to be associated with cardiovascular disease, metabolic syndrome and other diseases, It suggests that psoriasis may be a systemic disease. (6) the treatment of psoriasis should be regularly used to avoid the use of stimulant drugs.
【學(xué)位授予單位】：汕頭大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2011
【分類號】：R758.63

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