影响男性雄激素性脱发严重程度的相关因素及其皮肤镜特征分析  

Related factors affecting the severity of male androgenetic alopecia and the dermatoscopic features analysis

作　　者：丁娟 谢君 宋继权[1] DING Juan;XIE Jun;SONG Jiquan(Dept.of Dermatology,Zhongnan Hospital of Wuhan University,Wuhan 430071,Hubei,China)

机构地区：[1]武汉大学中南医院皮肤科,湖北武汉430071

出　　处：《武汉大学学报（医学版）》2023年第1期75-79,共5页Medical Journal of Wuhan University

基　　金：湖北省卫生和计划生育委员会联合基金资助项目(编号:WJ2018H0015);武汉大学中南医院交叉学科项目专项基金(编号:ZNXKPY2022026);武汉大学中南医院医学科技创新平台支撑项目(编号:PTXM2022031)。

摘　　要：目的:分析影响男性雄激素性脱发(AGA)严重程度的相关因素及不同严重程度的男性AGA患者的皮肤镜特征。方法:收集2021年8月—2022年4月就诊于武汉大学中南医院皮肤科门诊的男性AGA患者253例,年龄18~50岁,根据Norwood⁃Hamilton分级方法,将患者分为Ⅰ~Ⅶ级,其中轻中度患者142例,重度患者111例,收集研究对象的基本信息,包括身高、体重、家族史、吸烟、饮酒、运动、睡眠、熬夜的情况,并对每位患者进行皮肤镜检测,分别统计其单一毛发毛囊单位比例、黄点征、针尖样白点、毛周褐色环、分枝状血管、蜂窝状色素网、白色鳞屑的情况。采用SPSS 23.0统计软件进行Logistic回归分析,其中单毛囊的毛囊单位比例用t检验进行统计分析。结果:体质量指数(BMI)、家族史、吸烟、饮酒、熬夜、睡眠均与脱发严重程度呈正相关,OR值分别为1.192、2.051、1.001、0.99、1.344、0.553,P<0.05;运动与脱发严重程度不相关,P>0.05;皮肤镜表现:针尖样白点、蜂窝状色素网与脱发严重程度呈正相关,OR值分别为2.3、3.113,P<0.05;分枝状血管、白色鳞屑与脱发严重程度呈负相关,OR值分别为0.405、0.436,P<0.05;黄点征、毛周褐色环与脱发严重程度不相关,P>0.05;与轻中度组相比,重度组单一毛发毛囊单位比例显著升高(0.30 vs 0.17),P<0.05。结论:(1)BMI、家族史、吸烟、饮酒、熬夜、睡眠是AGA的加重因素;而运动不影响男性AGA的严重程度。(2)针尖样白点、蜂窝状色素网、分枝状血管、白色鳞屑可作为脱发严重程度的指标,单一毛发毛囊单位比例、针尖样白点、蜂窝状色素网是AGA的重度指标,分枝状血管、白色鳞屑是轻中度脱发的指标;黄点征、毛周褐色环不能作评价男性AGA严重程度的指标。Objective:To analyze the related factors influencing the severity of male androgenetic alopecia(AGA)and the dermatoscopic characteristics of male AGA with different severity.Methods:A total of 253 male AGA patients aged 18⁃50 years who were admitted to the Dermatology Department of Zhongnan Hospital of Wuhan University from August 2021 to April 2022 were enrolled.According to the Norwood⁃Hamilton classification method,the patients were divided into gradesⅠ⁃Ⅶ,including 142 mild to moderate patients and 111 severe patients.The basic information,height,weight,family history,smoking,drinking,exercise,sleep,and staying up were collected.Each patient was exam⁃ined by hair dermatoscopy,and the ratio of single hair follicle unit,the yellow dots,needle⁃like white dots,peripilar signs,branches of blood vessels,pigmentation between hair follicles,and white scales were counted.SPSS 23.0 statistical software was used for logistic regression analysis.Results:Body mass index(BMI),family history,smoking,drinking,staying up late and sleeping were positively correlated with the severity of alopecia(OR=1.192,2.051,1.001,0.99,1.344,0.553;P<0.05);Exercise was not associated with the severity of hair loss,P>0.05;By dermatoscopic features analy⁃sis,needle⁃like white dots and pigmentation between hair follicles were positively correlated with the severity of alopecia,while branching vessels and white scales were negatively correlated with the se⁃verity of alopecia,with OR values of 2.3,3.113,0.405,0.436,respectively(P<0.05).Yellow dots and peripilar signs were not correlated with the severity(P>0.05).Compared with the mild⁃moderate group,the proportion of single hair follicle unit was significantly higher in the severe group(0.30 vs 0.17,P<0.05).Conclusion:(1)BMI,family history,smoking,drinking,staying up late and sleeping were the aggravating factors of male androgenetic alopecia;while exercise did not affect the severity of AGA in men.(2)Needle⁃tip white dots,pigmentation between hair follicles,branching blood

关 键 词：雄激素性脱发 皮肤镜 Norwood⁃Hamilton 

分 类 号：R758.71[医药卫生—皮肤病学与性病学]