中国老年特应性皮炎多中心临床流行病学调查  

Multicenter clinical epidemiological analysis of elderly atopic dermatitis in China

作　　者：江夏 赵嘉惠[2] 唐汇洋 王若珺 张道军 汪旸[2] 李航[2] 郝飞 Jiang Xia;Zhao Jiahui;Tang Huiyang;Wang Ruojun;Zhang Daojun;Wang Yang;Li Hang;Hao Fei

机构地区：[1]重庆医科大学附属第三医院皮肤整形美容中心,重庆401120 [2]北京大学第一医院皮肤性病科、国家皮肤与免疫疾病临床医学研究中心皮肤病分子诊断北京市重点实验室、国家药品监督管理局化妆品质量控制与评价重点实验室,北京100034

出　　处：《中华医学杂志》2023年第32期2495-2501,共7页National Medical Journal of China

基　　金：国家自然科学基金(81903213);北大百度基金(2020BD012);重庆英才计划“包干制项目”(cstc2021ycjh‑bgzxm0291)

摘　　要：目的调查并分析我国老年特应性皮炎(AD)患者的临床特征。方法基于全国2型炎症性皮肤病临床研究与均质化诊疗项目,收集项目中172家三甲医院自2021年6月至2023年2月就诊的年龄≥65岁并诊断为AD患者的人口学信息、临床特征及疾病严重程度评估量表信息等,共2281例。将老年AD患者分别根据性别、有无过敏史(有过敏性疾病个人史或家族史与无过敏性疾病个人史或家族史)进行分组,分组后分别对临床特征(发病部位、AD体征)及评估量表等进行组内比较。所有计量资料采用M(Q_(1),Q_(3))表示。结果2281例老年AD患者年龄为73.02(68.83,79.62)岁,其中男性1649例(72.29%),女性632例(27.71%)。起病阶段共记录2244例,老年期起病1713例(76.34%)。过敏性疾病个人史或家族史共记录2136例,有过敏性疾病个人史或家族史者1076例(50.37%),无过敏疾病史1060例(49.63%)。皮损累及主要部位为腰背臀部,AD体征主要为面颊部和(或)头皮和(或)四肢伸侧的湿疹样皮损。中度及以上严重程度AD患者占60.58%(1327例),中重度瘙痒占81.32%(1781例),焦虑及抑郁分别占比46.14%(1011例)及39.27%(860例)。男性湿疹面积及严重程度评分(EASI)评估分数高于女性[9.67(4.77,19.28)比8.45(3.98,17.11)分](P=0.040),有过敏史患者EASI、医院焦虑抑郁量表(HADS)‑焦虑及过去1周最严重瘙痒数字评分量表(WI‑NRS)评估分数均高于无过敏史患者[9.79(4.84,19.96)比8.96(4.05,18.31)分,P=0.015;7.22(3.49,10.00)比6.81(3.12,9.33)分,P=0.012;7.64(5.62,9.07)比7.38(5.35,8.91)分,P=0.036]。结论老年AD患者有其特征性的临床表现。老年AD患者多为老年期起病,男性高于女性,皮损分布以伸侧为主,且疾病负担较重。Objective To investigate and analyze the clinical features of elderly atopic dermatitis(AD)in China.Methods Based on the National Clinical Research and Homogeneous Diagnosis and Treatment Project for Type 2 Inflammation Dermatosis,a total of 2281 patients aged 65 years or older were enrolled from 172 grade A tertiary hospitals who were diagnosed as atopic dermatitis from June 2021 to February 2023,and their demographics,clinical feature,and disease severity,etc.were collected.Elderly AD patients were divided into groups based on gender,history of allergic diseases(with or without a personal or family history of allergic diseases),and clinical features(site of onset,AD signs)and scales were compared within the groups.Median(Q_(1),Q_(3))was used for quantitative data.Results The age of 2281 elderly AD patients was 73.02(68.83,79.62)years old,among whom there were 1649 males(72.29%)and 632 females(27.71%).A total of 2244 cases were recorded with the information of the onset stage,of whom 1713 cases(76.34%)occurred in the elderly stage.A total of 2136 cases were recorded with the information of personal or family history of allergic diseases,of which 1076 cases(50.37%)had a personal or family history of allergic diseases,and 1060(49.63%)had no history of allergic diseases.Skin lesions were predominantly involved in the waist,back,buttocks,and AD signs were mainly eczema‑like skin lesions on the cheek and/or scalp and/or limb extension.Patients with moderate to severe AD accounted for 60.58%(1327 cases),moderate to severe itching accounted for 81.32%(1781 cases).Patients with anxiety and depression accounted for 46.14%(1011 cases)and 39.27%(860 cases),respectively.Men had a higher EASI score than women[9.67(4.77,19.28)vs 8.45(3.98,17.11),P=0.040].EASI,HADS‑anxiety and WI‑NRS scores were higher in patients with history of allergic diseases than those without allergy history[9.79(4.84,19.96)vs 8.96(4.05,18.31),P=0.015;7.22(3.49,10.00)vs 6.81(3.12,9.33),P=0.012;7.64(5.62,9.07)vs 7.38(5.35,8.91),P=0.036].Conclusion

关 键 词：皮炎 特应性 老年 临床流行病学调查 临床特征 

分 类 号：R758.2[医药卫生—皮肤病学与性病学]