女性寻常性痤疮与性激素的相关性研究  

The Relationship Between Female Acne Vulgaris and Sex Hormone

作　　者：李臻臻 周星 孙兆伟[1,3] 仲少敏 吴艳[1] LI Zhen-zhen;ZHOU Xing;SUN Zhao-wei;ZHONG Shao-min;WU Yan(Department of Dermatology and Venerology,Peking University First Hospital,Beijing Key Laboratory of Molecular Diagnosis on Dermatoses,National Clinical Research Center for Skin and Immune Diseases,Beijing 100034,China;Department of Dermatology,Beijing No.6 Hospital,Beijing 100007,China;Department of Dermatology,the First Hospital of Fangshsan District,Beijing 102400,China)

机构地区：[1]北京大学第一医院皮肤科北京市皮肤病分子诊断重点实验室国家皮肤与免疫疾病临床医学研究中心,北京100034 [2]北京市第六医院皮肤科,北京100007 [3]北京市房山区第一医院皮肤科,北京102400

出　　处：《中国美容医学》2020年第3期3-8,共6页Chinese Journal of Aesthetic Medicine

摘　　要：目的:探究女性寻常性痤疮患者性激素水平与痤疮发病及严重程度的相关性,指导临床对痤疮患者内分泌状态的评估。方法:对门诊就诊的520例寻常性痤疮女性患者进行横断面研究,分析其基础性激素水平、月经情况、伴发提示高雄激素的皮肤疾病及可能引起内分泌紊乱的不良生活习惯情况,和这些因素与痤疮严重程度的相关性。结果:女性寻常性痤疮患者中总睾酮TT高于正常的占22.3%;雌二醇E2低于正常的占8.0%,高于正常的占7.1%;孕酮P低于正常的占21.7%;卵泡刺激素FSH高于正常占19.2%。LH/FSH>2共5例(2.2%),均伴TT过高或处于正常高值;性激素异常程度在Ⅰ~Ⅲ级患者中与严重程度具有一定相关性,Ⅳ级患者性激素检查相对正常。90.9%的女性寻常性痤疮患者伴发不同形式月经异常,其中痤疮受月经周期影响者痤疮严重程度更重,且更容易出现性激素水平异常。女性寻常性痤疮患者伴发高雄相关皮肤问题,如:油性皮肤、脂溢性皮炎及多毛等多见,其中多毛与痤疮严重程度显著相关。不良生活习惯如睡眠不足可引起性激素水平改变,并与痤疮严重程度正相关。结论:女性寻常性痤疮患者在进行性激素水平解读时,不仅要关注雄激素水平,还要关注雌激素水平及上游促性腺激素的比例。成人期痤疮患者相比青春期型更可能伴有系统性内分泌异常,需要更积极地进行性激素水平筛查。对于伴有月经周期、经量异常及痤疮受月经影响者,以及伴有高雄相关其他皮肤问题者,性激素筛查及运用内分泌调节治疗的意义更大。Objective To investigate the relationship between sex hormone levels with the development and severity of acne vulgaris in female patients, and to provide guidance on the evaluation of endocrine status in clinical practice. Methods We conducted a cross-sectional study which included 520 female outpatients with acne vulgaris. We analyzed their basal sex hormone levels, menstruation, concomitance of other androgen-mediated cutaneous disorders, lifestyle habits which may lead to endocrine disorders, and the correlation between these factors with acne severity. Results Total testosterone(TT) levels were elevated in 22.3% of patients in our study, 8.0% of patients exhibited estradiol(E2) levels lower than normal range while 7.1% of patients showed E2 levels higher than normal range, 21.7% of patients showed decreased progesterone(P) levels, and 19.2% of patients showed elevated levels of follicle-stimulating hormone(FSH). 5 patients(2.2%) had LH/FSH>2, all accompanied with elevated or high-normal TT;the abnormality of sex hormone levels had a certain correlation with acne severity in grade I-III patients, while the hormone levels were relatively normal in grade IV patients. 90.9% of female acne patients had different forms of menstrual abnormalities;and among patients who had acne exacerbation related to menstrual cycle were more prone to have severe acne and abnormal sex hormone levels. Patients were often associated with other androgen-mediated cutaneaous disorders, such as oily skin, seborrheic dermatitis, hirsutism etc., among which hirsutism was strongly associated with increased acne severity. Unhealthy lifestyles including sleep-deprivation could lead to changes in sex hormone levels and is positively correlated with acne severity. Conclusion When interpreting the results of sex hormone levels, not only should we focus on androgen levels but also on estrogen levels and gonadotropin proportion. When compared with adolescent acne patients, adult acne patients were more likely to have systematic endocrine disorder

关 键 词：女性 寻常性痤疮 性激素 高雄相关皮肤病 生活习惯 

分 类 号：R758.733[医药卫生—皮肤病学与性病学]