银屑病住院患者1604例共患疾病临床分析

目的探讨银屑病及其共患疾病发病情况及影响因素。方法对上海市皮肤病医院2009年至2015年的1604例银屑病患者进行回顾性分析,比较银屑病与其共患疾病的相关性及影响因素。结果银屑病共患疾病主要有高血压、糖尿病、高脂血症、高尿酸血症、肝脏疾病（脂肪肝、肝炎、肝功能异常）、心血管疾病等。银屑病女性患者更易患心血管疾病(P＜0.05),男性更易患高脂血症、高尿酸血症(P＜0.05);从银屑病发病年龄看,有心血管病组较无心血管病组年龄大,糖尿病组较无糖尿病组大,高血压组较无高血压组大,高脂血症组较无高脂血症组大,高尿酸血症组较无高尿酸血症组大(P均＜0.05);有心血管病、高血压的患者银屑病平均病程长(P＜0.05);有吸烟史的银屑病患者更易罹患高脂血症(P＜0.05)。结论银屑病患者最易伴发血脂异常及肝脏疾病,其次为高血压、高尿酸血症、糖尿病,且性别、发病年龄、病程、家族史、吸烟史这5个因素可能是影响银屑病患者发生共患疾病的危险因素。     

202例白癜风临床类型与构成特点分析

目的：总结白癜风的临床类型与构成特点,以期为白癜风的临床防治提供依据。方法回顾性分析我院皮肤科2015年1~12月期间诊治的202例白癜风患者的临床资料。结果202例白癜风患者中男女比例为1：1.04;头面部是最常见的发病部位(占44.06%);临床分型中非节段型最常见(占84.65%),且以散发型多见(占49.01%);46例(占22.77%)患者伴发自身免疫性疾病或内分泌疾病,最多见者为甲状腺疾病(占8.91%);有家族史者占12.38%,有家族史者年龄为(19.16±7.75)岁,明显低于无家族史者的(22.28±8.16)岁,节段型、进展期比例分别为36%、92%,均高于无家族史者12.43%、71.75%,差异均有统计学意义(P<0.05);57例(28.22%)患者发病前存在明确的诱发因素。结论白癜风多以非节段型发病,皮损部位以头面部多见,常伴发自身免疫性疾病,精神心理因素是其发病的常见诱因,而有家族史的白癜风患者发病早、病情相对严重。     

红皮病型银屑病伴发代谢性疾病的临床分析

目的对红皮病型银屑病伴发代谢性疾病进行临床分析。方法对61例红皮病型银屑病伴发代谢性疾病患者做回顾性分析,并将其作为A组,将同期收入的58例斑块状银屑病患者,作为B组,56例急性荨麻疹患者定为C组。比较3组的伴发代谢相关疾病情况。结果对于高脂血症、代谢综合征以及出现腹型肥胖和高尿酸血症等,3组对比,A组的患病机率明显比B组高。对于HT（高血压）、MS（代谢综合征）、HLP（高血脂症）以及AO（腹型肥胖）、HUA（高尿血酸症）和斑块状银屑病伴发MD（代谢相关疾病）,A组的患病机率明显高于C组。男性红皮病型银屑病患者伴发HUA,A组的患病机率明显高于B、C组,以上差异均具有统计学意义（P〈0.05）。结论对于红皮病型银屑病伴发代谢性疾病种类,其大多与斑块状银屑病一致。其中红皮病型银屑病的男性患者伴发HUA机率,要高于斑块状银屑病男性患者。     

98例银屑病患者伴发代谢综合征的临床特点

目的总结分析银屑病伴发代谢综合征（metabolic syndrome,MS）患者的临床特征,为今后临床治疗该类患者提供参考依据。方法回顾性分析两院268例银屑病患者的临床资料,将伴MS患者列为研究组,未伴MS患者为对照组,对比分析两组患者体格检查和实验室检查各项指标。结果 268例患者中98例伴MS,占36.57%;研究组患者腰围、空腹血糖、血压、总胆固醇、甘油三酯均明显高于对照组（P〈0.05）,高密度脂蛋白明显低于对照组（P〈0.05）;研究组患者相比于对照组患者年龄大、发病年龄晚、病程长（P〈0.05）。研究组吸烟、饮酒者明显多于对照组（P〈0.05）。结论银屑病伴发代谢综合征发病率较高,且患者年龄大、发病年龄晚、病程长,和饮酒、吸烟等不良生活习惯密切相关,提示银屑病和代谢综合征具有某些共同的发病基础,要注重对银屑病患者的健康教育,积极预防其发生代谢综合征。     

PSORS1区域单核苷酸多态性rs1265181与汉族人银屑病表型相关性研究

目的 研究PSORSI区域单核苷酸多态性(SNP)rs1265181与汉族人银屑病临床表型(有无家族史、发病年龄、皮损类型)的相关性.方法 利用1 139例银屑病患者和1 132例对照的Illumina 610芯片基因分型数据,采用χ2检验比较sNP rs1265181等位基因和基因型在各表型分组问的分布频率差异.结果 rs1265181等位基因和基因型的分布频率在病例组与对照组、有家族史患者与无家族史患者之间的差异有显著性(P<0.05),在少儿发病患者与成人发病患者、点滴型患者与斑块型患者之间的差异无显著性(p>0.05).结论 SNP rs1265181 与汉族人银屑病的易感性相关,特别足与家族性银屑病相关性更为明显,但与银屑病患者的发病年龄、皮损类型可能无显著相关性.     

精神分裂症伴发代谢综合征者的相关危险因素及生活质量研究

目的:研究国内精神分裂症伴发代谢综合征者的患病率及生活质量,并分析可能的相关影响因素。方法:对602例住院精神分裂症患者进行问卷调查(包括国内修订的生活质量综合评定问卷等)和实验室测定空腹血糖及甘油三酯等,代谢综合征的诊断标准采用2004年中华医学会糖尿病分会代谢综合征标准。结果:精神分裂症患者中代谢综合征患病率为35.5%。与代谢综合征患病风险相关的危险因素包括年龄、性别、抗精神病药物种类及病程(P(0.05)。生活质量方面,精神分裂症伴发代谢综合征患者的躯体功能、心理功能和社会功能3个维度及总分显著低于非代谢综合征者(P<0.01)。精神分裂症患者的血糖、血压及BM I异常明显降低精神分裂症患者生活质量。结论:精神分裂症患者具有较高的代谢综合征发病风险,可能危险因素包括女性、高龄、病程长及服用氯氮平药物等。精神分裂症伴发代谢综合征者具有较差的躯体、心理及社会功能,可能与不良躯体状况有关。     

无高血压、高脂血症和糖尿病的急性脑梗死患者的病因

目的:探讨无高血压、高脂血症和糖尿病的急性脑梗死患者的发病原因,并分析这类患者发病的可能机制。方法:收集急性脑梗死的住院患者,详细调查其家族史、既往史、个人史以及各项检查和实验室指标,并依据病史及检查结果对没有高血压、高脂血症和糖尿病危险因素的患者进行统计分析。结果:89例患者中,高同型半胱氨酸血症22例(24.7%),有吸烟嗜好者35例(39.3%),有脑卒中家族史占10例(11.2%),有外伤史者24例(27.0%),慢支病史2例(2.2%),肿瘤患者6例(6.7%),独身6例(6.7%),丧偶3例(3.4%),心律失常(房颤)10例(11.2%)。各发病因素之间有重叠。结论:高同型半胱氨酸血症和吸烟、有外伤史与急性脑梗死存在密切关系,另外有脑卒中家族史和房颤也是发病的诱因,肿瘤患者、独身和丧偶人员也是高危人群。     

精神分裂症患者伴发代谢综合征的患病率调查

目的探讨精神分裂症患者伴发代谢综合征的患病率及其相关因素。方法选取2013年1-8月我院收治的精神分裂症患者428例,采用实验室测定法和问卷式调查,对428例患者进行标准的代谢综合征诊断,了解428例精神分裂症患者代谢综合征的发病率。结果根据428例精神分裂症患者分析,其中有130例患者伴发代谢综合征,男38例,女92例,精神分裂症伴发代谢综合征的发病率为21.5%,女性发病率明显大于男性发病率,文化程度低的患者发病率更高,已婚的发病率明显大于单身的,从精神分裂症患病时间看,9～20年的发病率较高,患者服用氯丙嗪、利培酮药物的发病率较高,而有疾病家族史的发病率要比无疾病家族史的发病率高。结论精神分裂症患者代谢综合征的发病率要高,女性患病时间长、服用氯丙嗪和利培酮药物、具有家族疾病史等危险因素是导致精神分裂症患者患有代谢综合症的主要原因。     

白癜风158例临床分析

【目的】 总结分析白癜风患者的临床特点,探讨白癜风的起病诱因【方法】 采用问卷调查的形式对158例白癜风门诊患者进行临床研究,用SPSS 17.0软件包进行统计分析【结果】 158例白癜风患者中男77例,女81例;平均发病年龄(25.4±15.3)岁;57.6%(91/158)的皮损累及头颈部;8.2%(13/158)的患者伴发甲状腺疾病;有阳性家族史者占11.4 %(18/158);51.3%(81/158)的患者能找到某种诱因,其中常见的诱因包括不良精神因素(30.4%)睡眠因素(22.2%)曝晒(8.9%)外伤(6.3%)过于劳累(5.7%)以及接触化学物质(5.7%)【结论】 白癜风好发于青少年;最常见的累及部位是面颈部;伴发率最高的疾病是甲状腺疾病;常见的发病诱因以精神与睡眠因素为主     

2087例痛风患者合并症及并发症的回顾性研究*

目的 调查住院痛风患者合并症及并发症的临床特点,并分析其影响因素。方法 采用回顾性的研究方法对2016年1月-2021年6月于云南省中医医院风湿科住院的2 087例痛风患者的人口学信息、病史、实验室检查等资料进行统计,分析合并症及并发症的分布情况及相关影响因素。结果 痛风患者合并症及并发症总的患病率为88.88%。合并症主要为代谢性疾病:高脂血症360例（17.25%）、糖尿病310例（14.85%）、脂肪肝731例（35.03%）;心血管疾病：高血压1 015例(58.63%)、冠心病220例（9.85%）、冠状动脉钙化86例（4.12%）;肺部损害：肺结节191例（9.15%）、肺间质纤维化35例（4.12%）;其他合并症：骨关节炎667例（31.96%）、肝损伤109例（5.22%）。并发病主要为肾脏疾病：肾结石389例（18.64%）、痛风性肾病244例（11.69%）、肾衰竭179例（8.58%）。影响合并症和并发症发生的危险因素较多,包括年龄、职业、长病程、血沉、C反应蛋白、低密度脂蛋白、高密度脂蛋白、甘油三酯、尿酸、肌酐等。结论 痛风患者合并症及并发症发病率高达88.88%。合并症中最多见的是代谢性疾病,其中脂肪肝发病率最高;并发症以肾脏疾病最多见,以肾结石发病率最高。年龄、职业、长病程、血沉、C反应蛋白等是其重要的危险因素。     

Anxiety,depression and harmful use of alcohol in severe chronic plaque psoriasis: A cross-sectional study

BackgroundPsoriasis is a common, chronic T cell–mediated disease characterised by erythematous, scaly plaques. Psoriasis is associated with depression, anxiety, poor quality of life, harmful use of alcohol and suicidal ideation. We performed this study to find out prevalence of psychological morbidity in our patients with severe psoriasis and to know clinical variables associated with higher risk of psychological morbidity.MethodThis study is a cross-sectional, observational study conducted in a dermatology outpatient department (OPD) of a tertiary care centre. Study population included patients with severe psoriasis area severity index (PASI>10). Clinical and epidemiological data, Patient health questionnaire-9, Generalised anxiety disorder-7, Dermatology life quality index (DLQI) and Alcohol Use Disorders Identification Test questionnaires were recorded. Data were analysed using SPSS, version 24. Chi-square test and Spearman's rank correlation test (ρ) were performed, and p value of <0.05 was considered statistically significant.ResultA total of 140 patients were included in the study and consisted of 67 men and 73 women. The median age was 44 years, median duration of disease was 10 years and median PASI was 13.6. Scoring revealed moderate-to-severe depression in 69 (49.3%) patients, moderate-to-severe anxiety in 40 (28.6%), severe impairment in quality of life in 98 (70%), harmful use of alcohol in 23 (16.4%) and suicidal ideation in 11 (7.8%) patients. Young age, recent onset, higher PASI and facial involvement show significant association with depression, anxiety and poor quality of life.ConclusionScreening for psychological morbidity should be performed in patients with severe psoriasis especially younger patients with recent onset disease. Higher DLQI points to concomitant psychological morbidity and it should be performed in all the patients.     

寻常型银屑病中医证候与年龄、病程关系的研究

目的探讨寻常型银屑病发病年龄(初次发病时的年龄)、年龄(接受证候调查时的年龄)、复发次数、总病程及本次病程与中医证候的相关性。方法按照临床流行病学群体研究方法,采用现况调查、多中心、大样本的研究设计,用EPIINFO 6.0建立数据库,统计分析应用SPSS软件,对2 675例寻常型银屑病发病年龄、病程等因素与中医证候关系进行分析。结果寻常型银屑病中血热证、血燥证、血瘀证最为常见,其中血热证1 489例(55.7%),血燥证593例(22.2%)和血瘀证323例(12.1%),以上3型之间发病年龄及患者年龄差异均有统计学意义(P<0.01),其中血燥证发病年龄最小,其次为血热证,血瘀证患发病年龄最大,血热证患者平均年龄最小,其次为血燥证,血瘀证患者平均年龄最大;血热证的复发次数少于血燥证和血瘀证(P<0.01);3型之中血热证的总病程和本次病程均最短,血燥证次之,血瘀证的总病程和本次病程最长(P<0.01)。结论血热证、血燥证和血瘀证是"从血论治"银屑病的基本证候,通过临床流行病学调查发现,这3个证候间不仅存在着时相性,而且治疗的难易程度也不同。     

复方泽漆颗粒治疗血热型银屑病临床观察及皮肤镜变化

目的 观察复方泽漆颗粒治疗血热型银屑病的疗效及治疗前后银屑病皮损区的皮肤镜表现。方法 将45例银屑病血热证患者随机分成治疗组23例和对照组22例,两组分别口服复方泽漆颗粒和复方青黛胶囊8周。采用银屑病面积与严重性指数（psoriasis area and severity index,PASI）对两组疗效进行评价,采用血管银屑病面积严重性指数（vascular psoriasis area and severity index,VPASI）对皮损区皮肤镜的变化进行评价。结果 两组临床疗效比较,差异有统计学意义（P＜0.05）,治疗组优于对照组;两组治疗后PASI评分、皮肤镜VPASI评分均较治疗前显著降低（P＜0.05）,且治疗组PASI评分、皮肤镜VPASI评分降低程度显著大于对照组,差异有统计学意义（P＜0.05）。结论 复方泽漆颗粒治疗血热证银屑病疗效较好;皮肤镜可用于评估血热证银屑病皮损恢复情况及药物疗效的观察。     

A clinical appraisal of patients with psoriasis treated in Seremban General Hospital, Malaysia

A prospective clinical study of 181 patients with psoriasis seen in Seremban General Hospital showed the incidence of psoriasis among dermatology outpatients was 2.15%. A significantly higher proportion of male patients were affected, with a male to female ratio of 1.7:1. Within the racial groups; 63 were Malays, 37 Chinese, and 81 Indians. There was a significantly higher proportion of Indians affected as compared with the races. The mean age of patients in this study was 43.7 years old but the mean age of onset of psoriasis in these patients was 33.1 years old. Thirty-one (17.1%) patients gave a positive family history of psoriasis and the mean age of onset of psoriasis was lower (29.3 years old) for patients with a positive family history. Plaque psoriasis was the commonest type of clinical presentation with the scalp being the commonest site affected. Psoriatic arthropathy was seen in 35 (19.3%) patients. Ninety-five (52.5%) patients gave a positive history of factors exacerbating their pre-existing disease and stress was singled out as the most common exacerbating factor.     

Increased psoriasis frequency in patients with familial Mediterranean fever

Objective: Familial Mediterranean fever (FMF) is a periodic fever syndrome caused by MEFV mutations. FMF may be associated with psoriasis in some cases. The prevalence of psoriasis in the normal Turkish population is 0.42%. We aimed to investigate the prevalence of psoriasis among FMF patients and their relatives.

Methods: FMF patients followed at Hacettepe University Adult and Pediatric Rheumatology Departments between January and August 2016 were included. FMF patients/their relatives were accepted to have psoriasis if the diagnosis was made by a dermatologist.

Results: A total of 351 FMF patients (177 adults; 174 children) were included. The median (min–max) age of adult and pediatric patients was 35 (19–63) and 10 (2–18) years, respectively. Thirteen (3.7%) FMF patients (11 adults, 2 children) had psoriasis. Psoriasis was more common in adult than pediatric patients (p?=?0.02). Psoriasis was present in 22 (12.4%) of adult and 9 (5.2%) of pediatric patients’ relatives (p?=?0.023). The frequency of psoriasis in ≥1 relatives of FMF patients was found to be 8.8%. Abdominal pain and fever were significantly higher, and arthralgia, arthritis, pleural chest pain, and pericarditis were significantly less frequent in the pediatric group than in adults (p?<?0.05).

Conclusion: Psoriasis was more common in FMF patients than in the normal population. Thus, FMF patients should be questioned and carefully examined for psoriasis lesions and psoriasis family history. Prospective multicenter studies may be important to find the incidence of psoriasis in FMF.     

类风湿关节炎患者风湿病家族史特征及临床意义

目的 分析类风湿关节炎(rheumatoid arthritis, RA)患者的风湿病家族史特征及其临床意义。方法 采用现场问卷调查方法,共调查890例RA患者,其中资料完整者803例,内容包括患者的性别、年龄、吸烟史、饮酒史、身高、体重、风湿病家族史、临床及血清学特征、疼痛和疾病总体评价、多维健康评估问卷等,并根据RA患者有无家族史进行分组比较。结果 本研究中,RA患者发病年龄为(45.09 ±14.50)岁,男女比例1 ∶3.5。有风湿病(包括RA、脊柱关节炎、干燥综合征、系统性红斑狼疮、系统性硬化症)家族史的患者123例(123/803, 15.32%), 其中一级亲属患病者占有家族史者73.98%(91/123),二级亲属患病者占有家族史者17.89%(22/123),一级+二级亲属均患病10例(8.13%)。家族史疾病种类以RA为主,为70.73%(87/123),其他风湿性疾病为21.95%(27/123),RA合并其他风湿病占7.32%(9/123)。根据有无家族史,对两组RA患者的人口学特征和临床指标进行比较,结果显示:在有家族史患者中,发病年龄提前6.04年[(39.97±13.68)岁 vs.(46.01 ±14.46)岁],类风湿因子阳性率高(78.48% vs. 66.67%), 差异具有统计学意义(P<0.05)。校正性别、体重指数及抗环瓜氨酸肽抗体等混杂因素后,有家族史患者的发病年龄提前4.54年(β = -4.54;95%CI:-8.70, -0.38;P < 0.05)。进一步分层分析发现,在吸烟RA患者中,有家族史者发病年龄提前10.02年,差异具有统计学意义(β = -10.02;95%CI:-17.60, -2.43;P = 0.01);而在不吸烟RA患者中,有家族史者发病年龄提前3.27年,差异无统计学意义(β = -3.27;95%CI:-8.37, 1.82;P= 0.21)。结论 风湿病家族史是RA发病提前的危险因素,与吸烟可能具有协同作用。     

Prevalence of metabolic syndrome in patients with psoriasis: a cross-sectional study in Singapore

INTRODUCTIONPsoriasis is a chronic inflammatory condition that affects the skin and joints, and is associated with cardiovascular risk factors, including metabolic syndrome (MetS). We aimed to assess the prevalence of MetS in patients with psoriasis and determine whether there was a correlation between psoriasis severity and MetS in a Singapore population.METHODSThis was a cross-sectional study of patients with psoriasis, aged 18–69 years, who attended a tertiary dermatology referral centre in Singapore from October 2007 to February 2009. Fasting glucose, lipids, blood pressure, Psoriasis Area and Severity Index, and body mass index were measured. MetS was diagnosed in the presence of three or more criteria of the modified National Cholesterol Education Program Adult Treatment Panel III.RESULTSAmong 338 patients with psoriasis, there were 238 (70.4%) men and 100 (29.6%) women, who were Chinese (n = 228; 67.5%), Malay (n = 52; 15.4%) and Indian (n = 58; 17.2%). The prevalence of MetS was 45.1%. MetS was 44% more prevalent in patients older than 50 years (p = 0.02). Malay patients with psoriasis were significantly more likely to have hypertriglyceridaemia, elevated fasting plasma glucose and abdominal obesity. There was no significant correlation between psoriasis severity and risk of MetS.CONCLUSIONThe prevalence of MetS in patients with psoriasis in Singapore was 45.1%, or nearly threefold higher than the Singapore general population. Patients with psoriasis should be screened yearly for MetS and any modifiable cardiovascular risk factors should be actively controlled.     

21-三体综合征相关急性白血病：21例报告

目的总结21-三体综合征（DS）相关急性白血病（AL）患儿的临床、实验室检查特点及疗效,提高诊疗水平。方法分析21 例DS-AL 患儿的临床表现、实验室检查、治疗及预后。结果与非DS-AL 相比,21 例DS-AL 患儿发病年龄1~5 岁为主（占 85.7%）,急性髓细胞白血病多见（占57.1%）,乳酸脱氢酶>2 倍以上者较多（占61.9%）;13 例行心脏彩超检查10 例异常（占 67.9%）,复杂型先天性心脏病常见（占38.5%）;6 例接受化疗,4 例完全缓解（占66.7%）,合并感染死亡2 例,治疗相关死亡率 33.3%;2例减强度化疗者已分别无病生存21月及43月。结论DS-AL以急性髓细胞白血病多见,对化疗敏感,采用减强度化疗 预后较好。     

泛发性脓疱型银屑病82例临床分析

目的：分析泛发性脓疱型银屑病(generalized pustular psoriasis,GPP)的临床特征、实验室检查及治疗方 法,揭示GPP的发病规律,评估其疗效转归。方法：回顾性分析中南大学湘雅二医院皮肤科82例(16例儿童,66例 成人)GPP患者的临床资料。结果：82例GPP患者发病男女之比为1:1.1。无寻常型银屑病史GPP患者(GPPPSO–)发病年 龄(25.5±21.2)岁,早于有寻常型银屑病史GPP患者(GPPPSO+)的(32.7±18.0)岁,GPPPSO–住院时间为(12.1±6.7) d,长于 GPPPSO+的(11.6±10.2) d。从寻常型银屑病转型至GPP的时间为(77.8±71.9)个月。儿童组以感染(33.3%)和药物(33.3%)为 主要诱发因素。成人组GPPPSO+患者以药物诱发(75.0%)为主,而GPPPSO–患者主要由感染因素(41.7%)诱发。阿维A治疗 效果确切。结论：儿童组及成人组GPP临床特点不尽相同。阿维A可作为GPP的一线药物,同时适用于儿童及成人, 慎用激素类药物。