藏族白癜风527例临床特点分析

【摘要】 目的 分析西藏地区藏族白癜风患者的临床特点。方法 回顾性分析 2018年1月至2019年12月于西藏自治区人民医院皮肤科门诊就诊的527例藏族白癜风患者的临床资料。结果 527例藏族白癜风患者中， 男女性别比例0.97∶1；发病年龄在10 ~ 30岁的患者263例（49.9%）。进展期 335例（63.6%），稳定期192例（36.4%）；节段型97例（18.4%），寻常型293例（55.6%），混合型79例（15%），未定类型58例（11%）。皮损位于面颈部253例（48%），躯干148例（28%），上肢64例（12%），下肢46例（9%），会阴肛周黏膜16例（3%）。春季发病154例（29.2%），夏季198例（37.6%），秋季98例（18.6%），冬季77例（14.6%）。140例（26.6%）伴发其他疾病，包括甲状腺疾病85例（16.1%），且74例（14.0%）为亚临床甲状腺疾病与白癜风伴发；22例患者至少1项血清免疫球蛋白或补体水平异常，其中包括进展期18例。与稳定期相比，进展期患者中促甲状腺激素（TSH）检测水平显著升高，两组间差异有统计学意义（P = 0.004）。Spearman等级相关分析显示，海拔水平与白癜风分期（rs = -0.18，P < 0.001）呈低度相关。白癜风分期与TSH（rs = -0.12，P = 0.005）、补体C3（rs = -0.09，P = 0.041）呈低度负相关，分型与TSH（rs = -0.11，P = 0.011）呈低度相关。结论 西藏地区藏族白癜风患者以10 ~ 30岁发病为主，发病部位以面颈部为主，春夏季发病多见，甲状腺功能异常的发生率高。

Clinical characteristics of 527 patients of Tibetan nationality with vitiligo

【Abstract】 Objective To analyze clinical characteristics of patients of Tibetan nationality with vitiligo in the Tibet autonomous region. Methods Clinical data were collected from 527 patients of Tibetan nationality with vitiligo, who visited Department of Dermatology, People′s Hospital of Tibet Autonomous Region from January 2018 to December 2019, including age, gender, seasons at onset, involved body sites, classification, stages, concomitant diseases and laboratory test results. Results Among the 527 patients of Tibetan nationality with vitiligo, the ratio of male to female was 0.97∶1, and vitiligo usually occurred at 10 -30 years of age. As for clinical staging, 335（63.6%） patients were diagnosed with progressive vitiligo, and 192 （36.4%）with stable vitiligo; as for clinical classification, there were 97（18.4%） patients with segmental vitiligo, 293（55.6%）with vitiligo vulgaris, 79 （15%） with mixed vitiligo and 58 （11%）with unclassified vitiligo; vitiligo lesions were mainly located on the face and neck （253 cases, 48%）, followed by the trunk （148 cases, 28%）, upper limbs（64 cases, 12%）, lower limbs（46 cases, 9%）, and perineal and perianal mucosa（16 cases, 3%）; vitiligo usually occurred in summer （198 cases, 37.6%）and spring（154 cases, 29.2%）, followed by autumn（98 cases, 18.6%） and winter（77 cases, 14.6%）; 140 （26.6%） patients suffered from other diseases, such as thyroid diseases（85 cases, 16.1%）, and 74 （14.0%） suffered from subclinical thyroid diseases; one or more serological abnormalities were observed in 22 patients, including 18 with progressive vitiligo. Compared with the patients with stable vitiligo, those with progressive vitiligo showed significantly increased thyroid stimulating hormone （TSH） levels （P = 0.004）. Spearman rank correlation analysis showed that the altitude was weakly correlated with the stage of vitiligo （rs = -0.18, P < 0.001）, the stage of vitiligo was weakly negatively correlated with the TSH level （rs = -0.12, P = 0.005） and complement C3 level（rs = -0.09, P = 0.041）, and the classification of vitiligo was weakly correlated with the TSH level （rs = -0.11, P = 0.011）. Conclusion In this study, the patients of Tibetan nationality with vitiligo were mostly aged at 10 - 30 years, vitiligo lesions were mainly located on the face and neck, and usually occurred in spring and summer, and the prevalence of comorbid thyroid dysfunction was relatively high.