黄褐斑病因、加重因素及对生活质量影响的横断面研究  

Etiology and aggravating factors of melasma and its influence on quality of life： a cross-sectional study

作　　者：王辉[1] 郭丽芳[1] 葛一平[1] 吴余乐[1] 吴秋菊[1] 张孟丽[1] 王千秋[2] 林彤[1] 

机构地区：[1]中国医学科学院北京协和医学院皮肤病研究所激光科,南京210042 [2]中国医学科学院北京协和医学院性病临床防治室,南京210042

出　　处：《中华皮肤科杂志》2016年第2期93-97,共5页Chinese Journal of Dermatology

基　　金：江苏省自然科学基金（BK2012507）

摘　　要：目的研究黄褐斑患者的病因、加重因素及对生活质量的影响。方法通过问卷形式收集166例女性黄褐斑患者的人口学资料、行为学资料、临床资料，并计算黄褐斑面积及严重程度评分（MASI）、皮肤病生活质量评分（DLQI）、黄褐斑生活质量评分（MELA—SQOL）。通过多元线性回归分析，寻找黄褐斑严重程度及患者生活质量影响因素。结果33．13％（55／166）的患者在发病前1年内有怀孕史。4．82％（8／166）的患者发病前1个月内有明确日光暴晒史。患者MASI评分（5．99±4．01）分，DLQI评分（4．34±4．41）分，MELASQOL评分（30．54±17．91）分。黄褐斑MELA—SQOL评分随着年龄的增长降低（β=-0．220，t=2．874，P〈0．05），随着皮损颜色的加深上升（β=0．217，t=2．827，P〈0．05）。绝经前黄褐斑患者随着年龄的增长MASI评分增加（β=0．244，t=3．387，P=0．001），Fitzpatrick皮肤分型为Ⅳ型的患者MASI评分较Ⅲ型皮肤高（β=0．322，t=4．615，P〈0．001）。结论黄褐斑的发病与激素水平波动和日晒有关。黄褐斑颜色越深、年龄越小的患者生活质量受黄褐斑的影响越大。Fitzpatrickl Ⅳ患者较Ⅲ型的患者黄褐斑更重。绝经前黄褐斑患者随着年龄增长皮损有加重趋势。Objective To investigate the etiology, aggravating factors of melasma and its influence on quality of life in patients. Methods Demographic, behavioral and clinical data were collected from 166 female patients with melasma through a questionnaire survey. Melasma area severity index （MASI）, dermatology life quality index （DLQI） and melasma quality of life scale （MELA-SQOL） were calculated. Multiple linear regression analysis was carried out to identify factors influencing melasma severity and quality of life in patients. Results Of the 166 patients, 55 （33.13%） had a history of pregnancy within 1 year before the occurrence of melasma, and 8 （4.82%） had a history of sun exposure within 1 month before it. The MASI, DLQI and MELA-SQOL scores were 5.99 ± 4.01, 4.34 ± 4.41 and 30.54 ± 17.91 in these patients respectively. Multiple linear regression analysis showed that the MELA-SQOL score significantly decreased with age （β = -0.220, t = 2.874, P 〈 0.05 ）, but increased with deepening of skin color （β = 0.217, t = 2.827, P 〈 0.05 ）. Moreover, the MASI score significantly increased with age among premenopausal patients with melasma （β = 0.244, t = 3.387, P = 0.001 ）, and higher in patients with Fitzpatrick skin type Ⅳ than in those with Fitzpatrick skin type Ⅲ（β = 0.322, t = 4.615, P 〈 0.001 ）. Conclusions The occurrence of melasma is associated with fluctuation of hormone levels and sun exposure. The darker the lesion color and the younger the age, the greater the impact on the quality of life in patients with melasma. Melasma is more severe in patients with Fitzpatrick skin type IV than in those with Fitzpatrick skin type Ⅲ, and seems to exacerbate with age among premenopausal patients.

关 键 词：黄褐斑 人口统计学 疾病特征 生活质量 横断面研究 病因 加重因素 

分 类 号：R758.42[医药卫生—皮肤病学与性病学]