寻常性银屑病自然病程的长期随访研究  

Natural history of psoriasis vulgaris： a long-term follow-up study

作　　者：汤占利[1] 陈官芝[1] 潘敏[1] 彭永年[1] 郑人范[2] 

机构地区：[1]青岛大学医学院附属医院皮肤科,266003 [2]青岛市立医院皮肤科

出　　处：《中华皮肤科杂志》2013年第10期695-697,共3页Chinese Journal of Dermatology

摘　　要：目的探讨寻常性银屑病的自然病程变化。方法在经过长期随访的1136例中，选择初次发病后3个月内就诊的患者作为对象，将就诊后长达20年以上的病情变化情况进行整理、归类，并将每例的发病年龄、就诊时皮疹的形态、分布范围，是否有家族史，是否使用抗癌药、或使用维生素、中药等信息逐项进行登记，然后用SPSS13．0统计学软件与病情演变类型之间进行相关性分析。结果寻常性银屑病的病程演变有6种类型，即即愈型、缓愈型、间歇发作型、频发轻型、频发中型、频发重型。初发病例经长期随访，约有30％的患者处于长期痊愈状态（即愈型＋缓愈型），频发重型不足10％。经与病程演变类型相应的随访时病情严重程度（轻、中、重）与影响因素相关的统计学分析显示，发病年龄和家族史有相关性，使用抗癌药治疗有显著的负相关。结论长期随访的寻常性银屑病患者的资料能反映病程演变过程（即自然病程）的情况，对判断银屑病患者的预后、预防复发、选择治疗方法有一定的指导意义。Objective To characterize the natural history of psoriasis vulgaris. Methods A retrospective study was carried out. Totally, 245 patients admitted to hospitals within three mouths after the first episode of psoriasis vulgaris were selected from 1136 patients with psoriasis vulgaris who had been followed up for more than 20 years. Changes in disease severity during the long-term follow-up were traced, and information on the shape and distribution of skin lesions, family history, use of anticancer drugs, vitamins and traditional Chinese medicines was collected and analyzed. SPSS13.0 software package was utilized to assess factors associated with the evolution of psoriasis vulgaris. Results The natural course of psoriasis vulgaris could be classified into six types： immediate healing, slow healing, intermittent relapse, frequent mild relapse, frequent moderate relapse, and frequent severe relapse. The immediate healing type and slow healing type amounted to 30% of these patients, and the frequent severe relapse type to less than 10%. Statistical analysis revealed that the clinical severity of psoriasis was associated with the age of onset and family history, and was negatively correlated with the use of anticancer drugs. Conclusions The long-term follow-up study reveals the natural course of psoriasis vulgaris, which may be helpful in guiding the prediction of prognosis, prevention of recurrence and selection of treatment.

关 键 词：银屑病 随访研究 时间 

分 类 号：R758.63[医药卫生—皮肤病学与性病学]