定点测距分级在男性雄激素性脱发中的适用性研究  

A study on the applicability of the distance between facial marks classification of male androgenic alopecia

作　　者：戚吉妮 蒋宙男 程含皛 侯觉 屠静怡 周玥 徐伟力 赵钧 周圳滔 周易 毛俊杰 钱锡飞 范崇祥 张菊芳 吕中法[8] Qi Jini;Jiang Zhounan;Cheng Hanxiao;Hou Jue;Tu Jingyi;Zhou Yue;Xu Weili;Zhao Jun;Zhou Zhentao;Zhou Yi;Mao Junjie;Qian Xifei;Fan Chongxiang;Zhang Jufang;Lyu Zhongfa(The Fourth Clinical Medical College of Zhejiang Chinese Medical University,Hangzhou First People’s Hospital,Zhejiang University School of Medicine,Hangzhou 310006,China;Department of Plastic Surgery,Hangzhou First People’s Hospital,Zhejiang University School of Medicine,Hangzhou 310006,China;Department of Burn and Plastic Surgery,No.903 Hospital of PLA Joint Logistic Support Force,Hangzhou 310013,China;Department of Plastic Surgery,Hangzhou First People’s Hospital Chengbei Branch,Zhejiang University School of Medicine,Hangzhou 310003,China;Department of Plastic Surgery,the First People’s Hospital of Xiaoshan District in Hangzhou,Hangzhou 311200,China;Department of Medical Cosmetology,Hangzhou Ninth People’s Hospital,Hangzhou 310000,China;the First Clinical Medical College of Zhejiang Chinese Medical University,Hangzhou 310053,China;Department of Dermatology,the Second Affiliated Hospital of Zhejiang University School of Medicine,Hangzhou 310009,China)

机构地区：[1]浙江中医药大学第四临床医学院,浙江大学医学院附属杭州市第一人民医院,杭州310006 [2]浙江大学医学院附属杭州市第一人民医院整形外科,杭州310006 [3]解放军联勤保障部队第九○三医院烧伤整形科,杭州310013 [4]浙江大学医学院附属杭州市第一人民医院城北院区整形外科,杭州310003 [5]杭州市萧山区第一人民医院整形外科,杭州311200 [6]杭州市第九人民医院医疗美容科,杭州310000 [7]浙江中医药大学第一临床医学院,杭州310053 [8]浙江大学医学院附属第二医院皮肤科,杭州310009

出　　处：《中华整形外科杂志》2023年第2期125-133,共9页Chinese Journal of Plastic Surgery

基　　金：国家自然科学基金(81972959);杭州市医学重点学科(0020200044)。

摘　　要：目的探讨定点测距分级在评估男性雄激素性脱发严重程度中的适用性。方法 2019年6至12月于杭州市第一人民医院脱发专科门诊根据定点测距分级及BASP(basic and specific)分级对诊断明确的中国男性雄激素性脱发患者进行评估。定点测距分级基于患者毛发的测量数据进行评级,通过测量前发际线定点至眉水平线的距离、发旋中心的最长脱发半径,评估患者额(F)、颞(M)、顶(V)部毛发退缩情况,将各区域脱发情况由轻到重评为0~3级,最终脱发分级表示为FnMnVn形式(如F1M2V0)。以F、M、V中最高的脱发等级作为患者整体脱发分级。采用SPSS 25.0软件统计分析患者一般资料,采用Kappa检验评估定点测距分级与BASP分级结果间的一致性;通过3位脱发专科医生评级的重复率检验定点测距分级的重复性;3位脱发专科医生中2位及以上有相同评价的患者,将该评价结果视作标准结果,通过2位临时培训的普通医生的分级结果与标准结果的一致率检验定点测距分级的易用性。结果共纳入150例男性患者,年龄(32.8±7.9)岁(19~58岁),其中24~35岁者99例,占66.00%,可以观察到患者发病年龄偏早。经定点测距分级评估,150例患者中轻度脱发的人数最多[65例(43.33%)],其次为重度脱发[58例(38.67%)],与BASP分级所得结果的一致性中等(κ=0.573,P<0.001)。3位经验丰富的脱发专科医生通过定点测距分级对150例患者进行评估的结果显示,额、颞、顶部分级结果的重复率分别为98.00%(147/150)、97.33%(146/150)和96.00%(144/150),最终脱发分级的重复率为92.00%(138/150),整体脱发分级的重复率为98.00%(147/150)。2名临时培训的普通医生的整体脱发分级结果与标准结果的一致率分别为95.92%(141/147)与96.60%(142/147),且除其中1位普通医生在最终分级方面与标准结果的一致率为89.86%(124/138)外,其余结果一致率均高于90.00%。结论定点测距分级是一种针对中国�Objective To explore the applicability of the distance between facial marks classification in evaluating the severity of androgenic alopecia in men.Methods From June to December 2019,the male Chinese with diagnosis of androgenic alopecia were evaluated in the specific clinic of alopecia of Hangzhou First People’s Hospital according to the distance between facial marks and BASP(basic and specific)classification.The classification based on the distance between facial marks measures the distance from the facial marks of the anterior hairline to the horizontal line of the eyebrow and the longest radius of hair loss in the hair rotation center,the hair recession of the patient’s forehead(F),temporal(M)and vertex(V)parts.The hair loss in each region is rated as 0-3 grade from light to heavy,and the final hair loss grading is expressed as FnMnVn,such as F1M2V0.The highest grade of hair loss in F,M and V is the overall grade of hair loss.SPSS 25.0 software was used to statistically analyze the general data of patients,and Kappa test was used to evaluate the consistency between the results of the distance classification and BASP classification.The repeatability of the distance classification was tested by the repetition rate of three hair loss specialists.When two or more specialists gave the same evaluation among the three hair loss specialists,the result was regarded as the standard result.The ease of use of the distance between facial marks classification was tested by the consistency rate between the grading results of two temporary trained general doctors and the standard results.Results A total of 150 male patients,aged(32.8±7.9)years(19-58 years),were included,of which 99 patients were 24-35 years old,accounting for 66.00%.It can be observed that the onset age was earlier.As assessed in this classification,the patients who participated in the study were graded as mild in 65 cases(43.33%),severe in 58 cases(38.67%),and moderate,which was consistency with the results obtained by BASP classification(κ=0.573,P<0.

关 键 词：脱发 男性雄激素性脱发 脱发分级 脱发诊断 定点测距 

分 类 号：R758.71[医药卫生—皮肤病学与性病学]