复方倍他米松注射液联合治疗后进展期非节段型白癜风稳定率及影响因素分析  

Analysis of disease control rate and its influencing factors in patients with progressive non-segmental vitiligo after combined treatment with compound betamethasone injection

作　　者：张迪敏[1] 曹成 周妙妮[1] 盛安琪 林福全[1] 许爱娥[1] Zhang Dimin;Cao Cheng;Zhou Miaoni;Sheng Anqi;Lin Fuquan;Xu Ai′e(Department of Dermatology,Hangzhou Third People′s Hospital,Hangzhou 310009,China)

机构地区：[1]杭州市第三人民医院皮肤科,杭州310009

出　　处：《中华皮肤科杂志》2024年第4期350-354,共5页Chinese Journal of Dermatology

基　　金：国家自然科学基金联合基金项目(U22A20310);国家自然科学基金(82003322);浙江省自然科学基金(LY21H110002)。

摘　　要：目的探讨复方倍他米松注射液联合治疗进展期非节段型白癜风患者后病情稳定率及影响因素。方法回顾性收集2022年10月至2023年4月杭州市第三人民医院皮肤科白癜风专病门诊就诊并接受复方倍他米松注射液联合治疗的进展期非节段型白癜风患者,记录治疗后3个月的皮损稳定率。分析发病特征、病程、病情或治疗方法等因素对白癜风稳定率的影响。计数资料的组间比较采用χ2检验。采用logistic回归分析治疗效果的影响因素。结果纳入145例复方倍他米松注射液联合治疗的进展期非节段型白癜风患者,男56例,女89例,14~67(35.43±11.54)岁。18例接受1次注射,稳定10例(55.6%);105例注射2次,稳定62例(59.0%);22例注射3或4次,稳定12例(54.5%)。治疗后总体稳定率为57.9%(84例)。白斑面积<1%体表面积的患者治疗稳定率(42/47,89.4%)高于白斑面积≥1%的患者(42/98,42.9%,P<0.001);病程≤2年的患者治疗稳定率(32/41,78.0%)高于病程>2年的患者(52/104,50.0%,P<0.05);伴特殊临床标记(同形反应、三色白癜风、纸屑样外观、炎症性白癜风等)的患者(4/21,19.0%)治疗稳定率低于无临床标记组(80/124,64.5%,P<0.001)。快速进展期患者复方倍他米松注射液治疗同时联合光疗组的稳定率高于未联合光疗组[(33/44,75.0%)比(21/44,47.7%),χ^(2)=6.90,P=0.009]。白斑面积≥1%且复方倍他米松注射液治疗2次的患者中,联合光疗组的稳定率(21/36,58.3%)也高于未联合光疗组(12/37,32.4%;χ^(2)=4.94,P=0.026)。是否为初发、是否有发病诱因、是否有家族史、不同白癜风疾病活动度评分、不同治疗次数和间隔时间的患者组间,治疗后稳定率差异无统计学意义(均P>0.05)。多因素logistic回归分析显示,白斑面积大小(OR=8.11,95%置信区间:2.74~24.04)、病程长短(OR=0.26,95%置信区间:0.07~0.99)、有无特殊临床标记(OR=6.37,95%置信区间:1.72~23.57)和是否联合光疗(OR=0.34,95%置信区间:Objective To investigate the disease control rate and its influencing factors in patients with progressive non-segmental vitiligo after combined treatment with systemic compound betamethasone injection(CBI).Methods A retrospective analysis was conducted on the patients with progressive non-segmental vitiligo,who visited and were treated with CBI in the Department of Dermatology,Hangzhou Third People′s Hospital from October 2022 to April 2023.The disease control rate was analyzed after 3-month treatment.Effects of clinical factors such as disease onset characteristics,duration,disease condition and treatment methods on the disease control rate were analyzed.Chi-square test was used for comparisons of enumeration data between groups,and logistic regression analysis was conducted to analyze factors influencing the efficacy.Results A total of 145 progressive non-segmental vitiligo patients treated with CBI were collected,including 56 males and 89 females,aged 14-67(35.43±11.54)years.Among the 18 patients having received an intramuscular injection of CBI,10(55.6%)obtained stable condition;among the 105 having received 2 injections of CBI,60(59.0%)obtained stable condition;among the 22 having received 3 or 4 injections of CBI,12(54.5%)obtained stable condition.The overall disease control rate after treatment was 57.9%(84 cases).The disease control rate was significantly higher in the patients with the lesional area<1%body surface area(BSA)(42/47,89.4%)than in those with the lesional area≥1%BSA(42/98,42.9%;P<0.001),significantly higher in the patients with disease duration≤2 years(32/41,78.0%)than in those with disease duration>2 years(52/104,50.0%;P<0.05),and significantly higher in the patients treated with CBI combined with phototherapy(33/44,75.0%)than in those treated with CBI alone(21/44,47.7%;χ^(2)=6.90,P=0.009),but significantly lower in the patients with special clinical markers(Koebner phenomenon,trichrome vitiligo,confetti-like depigmentation,inflammatory vitiligo,etc.,4/21,19.9%)than in those without

关 键 词：白癜风 糖皮质激素类 治疗结果 光疗法 进展期白癜风 复方倍他米松注射液 

分 类 号：R758.41[医药卫生—皮肤病学与性病学]