手部白癜风255例临床表型的聚类分析  

Cluster Analysis of Clinical Phenotypes in 255 Patients with Hand Vitiligo

作　　者：胡媛 张江安[1] 孙莉婷 孙钰桢 张涵茵 毛雨 于建斌[1] HU Yuan;ZHANG Jiang'an;SUN Liting;SUN Yuzhen;ZHANG Hanyin;MAO Yu;YU Jianbin(Department of Dermatology,the First Affiliated Hospital of Zhengzhou University,Zhengzhou,450052,China)

机构地区：[1]郑州大学第一附属医院皮肤科,河南郑州450052

出　　处：《中国皮肤性病学杂志》2023年第3期291-298,共8页The Chinese Journal of Dermatovenereology

基　　金：国家自然科学基金项目(U180410045)。

摘　　要：目的采用聚类分析探讨手部白癜风的临床分型及其意义。方法招募2019年4月-2022年2月在郑州大学第一附属医院皮肤科就诊的手部白癜风患者,并收集患者的临床资料。将手部白癜风划分为8个区域,采用Image J计算各区域白斑面积,对白斑的部位及其面积进行聚类分析,聚类分析采用迭代分区的k-means聚类,距离算法采用欧式距离法。结果共招募255例手部白癜风患者,其中男181例(70.98%),女74例(29.02%),就诊年龄8~68岁[(33.57±12.81)岁],发病年龄6~62岁[(28.09±12.64)岁],病程0~30年[(5.57±6.38)年]。聚类分析示手部白癜风可分为三类不同亚型,各型在就诊年龄、病程、累及部位(腹部、腕部和下肢)、全身皮损的体表面积(body surface area,BSA)差异均有统计学意义(P<0.05):手指型(166例,65.10%)为最常见类型,就诊时较年轻,病程较短,主要累及手指伸侧等易受摩擦部位,BSA<1%为主;手背型(66例,25.88%)次之,就诊时较年轻,病程较短,以累及手背为主,易合并累及腹部(P=0.008)、腕部(P=0.003)及下肢(P<0.001),BSA>5%多于另外两型(P<0.001);手掌型(23例,9.02%)以累及手掌为主,最为罕见,就诊时较年老(P<0.05),病程较长(P<0.05),BSA在1%~5%之间多见。结论基于聚类分析,手部白癜风可分为手指型、手掌型和手背型,三类各具有不同临床特点。Objective To explore the clinical classification and significance of hand vitiligo by cluster analysis.Methods Patients with hand vitiligo who presented to the Department of Dermatology,the First Affiliated Hospital of Zhengzhou University from April 2019 to February 2022 were recruited.For all patients,their clinical data were collected.Hand vitiligo was divided into 8 regions,Image J was used to calculate the percentage of vitiligo area in each region,and cluster analysis was performed on region and the percentage.K-means clustering with iterative partitioning was used for cluster analysis,and Euclidean distance method was used for distance algorithm.Results A total of 255 patients with hand vitiligo were recruited,including 181 males(70.98%)and 74 females(29.02%);the age at diagnosis and onset were 8-68 years(33.57±12.81)years and 6-62 years(28.09±12.64)years,respectively,and the duration of disease was 0-30 years(5.57±6.38)years.Cluster analysis showed that hand vitiligo could be divided into three different subtypes,and for each subtype,there were statistically significant differences in age,disease duration,affected parts(abdomen,wrist and lower extremities),and body surface area(BSA)of skin lesions of the whole body(P<0.05),with finger subtype(166 cases,65.10%)as the most common subtype,with younger age,shorter duration of disease,mainly affecting the extensor part of fingers,and mainly BSA<1%.The dorsal hand subtype(66 cases,25.88%)was the second most common,with younger age,shorter duration of disease,mainly involving dorsal hand,and easily involving abdomen(P=0.008),wrist(P=0.003)and lower limbs(P<0.001),and BSA>5%,which was obviously more than the other two subtypes(P<0.001).Palmar subtype(23 cases,9.02%)mainly affected the palm,which was the rarest,and generally found in patients with older age(P<0.05),longer duration of disease(P<0.05),and BSA of 1%-5%.Conclusion Based on cluster analysis,hand vitiligo can be divided into finger subtype,palm subtype and dorsal hand subtype,and each of the three su

关 键 词：白癜风 手部 聚类分析 表型 

分 类 号：R758.41[医药卫生—皮肤病学与性病学]