浙江省339例迟发型白癜风临床分析

目的 探讨迟发型白癜风的临床特征和流行病学情况.方法 采用问卷调查形式对339例迟发型白癜风患者(发病年龄>30岁)进行临床研究,并以早发型患者(发病年龄<30岁)作对照,用SPSS 16.0软件包对数据进行分析.结果 339例迟发型白癜风患者中男110例占32.4%,女229例占67.6%,女性显著多于男性.而早发型患者男女比例差异无统计学意义.平均发病年龄(45.4±10.8)岁,228例(67.3%)患者在31～50岁之间发病.头颈部是最常见的发病部位,迟发型白癜风患者首发于上肢的比例显著高于早发型白癜风患者.迟发型白癜风患者节段型、局限型比例显著低于早发型患者的比例,散发型、肢端型患者比例显著高于早发型患者.252例(74.3%)迟发型患者处于进展期,105例(31.0%)患者伴有毛发变白.迟发型患者伴发自身免疫性或内分泌疾病的比例(8.8%)与早发型患者(5.9%)比较,差异无统计学意义,但伴发甲状腺疾病及糖尿病的比例显著高于早发型患者(P<0.05).迟发型患者家族史阳性比例为9.1%,早发型患者为12.8%,两组间差异无统计学意义.与早发型患者相比,迟发型患者中环境因素为诱因者所占比例明显增高,且以精神因素为主.结论 迟发型白癜风患者和早发型患者在临床特征和流行病学方面存在一定的差异.

Clinical analysis of 339 cases of late onset vitiligo in Zhejiang province

Objective To study clinical features and epidemiology of late onset vitiligo in Zhejiang province.Methods Using a standardized questionnaire,clinical analysis was carried out in 339 patients who developed vitiligo after 30 years of age(late onset)as well as on 758 patients developing vitiligo before 30 years of age(early onset)as control.The findings were analyzed by SPSS 16.0 software.Results There were 229 females and 110 males in the 339 patients with late onset vitiligo,while of the 758 patients with early onset vitiligo,375 were males and 383 females.In late onset vitiligo,the average onset age was 45.4±10.8 years with head and neck as the predilection sites.A significant increase was observed in the proportion of patients with upper limbs as the primary location in patients with late onset vifiligo than in those with early onset vitiligo(22.7%vs 12.9%,χ2=16.73,P<0.05).Compared with patients with early onset vitiligo,the prevalence of segmental vitiligo and localized vitiligo decreased (9.4%vs 20.1%,11.2% vs 16.5%,both P<0.05),while that of sporadic vifiligo and extremity vitiligo increased(57.8%vs 50.1%,16.8%vs 10.8%,both P<0.05)in those with late onset vitiligo.Of the patients with late onset vitiligo,252 (74.3%)were in progressive stage and 105(31.0%)suffered from leukotrichia.No significant difference was found in the prevalence of autoimmune or endocrine disorders between patients with late onset vitiligo and those with early onset vitiligo(8.8%vs 5.9%,P>0.05),while increased incidence of thyroid diseases and diabetes mellitus was noted in patients with late onset vitiligo(both P<0.05).A family history was observed in 31(9.1%)patients with late onset vitiligo and 97(12.8%)patients with early onset vitiligo(P>0.05).Compared with early onset vitiligo,late onset vitiligo was more vulnerable to environmental factors,and mental factors appeared to be the primary influencing factor.Conclusion There are some differences in clinical and epidemiological profiles between late onset vitiligo and early onset vitiligo.