寻常型银屑病合并代谢性综合征临床研究

目的:回顾性分析寻常型银屑病伴代谢综合征的临床特点。方法:对206例寻常型银屑病患者进行回顾性调查,录入患者基本信息及观察指标包括身高、体质量、血压、空腹血糖(FBG)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、总胆固醇(TC)及尿酸(UA),对中医证型进行辨证,并对银屑病患者皮损严重程度面积及严重程度进行银屑病皮损面积及严重度指数(PASI)评估;代谢综合征诊断标准采用2005年国际糖尿病联盟制定的标准。比较伴代谢综合征者(MS组)与不伴有代谢综合征者(非MS组)的年龄、病程、血压、体质量指数(BMI)、生化指标、中医证型及PASI评分情况。结果:206例寻常型银屑病患者中伴代谢综合征者46例,占22.33%;不伴有代谢综合征者160例,占77.67%。2组病程比较,差异无统计学意义(P>0.05);2组年龄比较,差异有统计学意义(P<0.05),2组各年龄阶段患者分布比较,差异均有统计学意义(P<0.05)。其中MS组患者以46~55岁居多,非MS组患者以36~45岁居多。MS组收缩压(SBP)、舒张压(DBP)、FBG、TG、BMI、UA均高于非MS组,而HDL-C低于非MS组,差异均有统计学意义(P<0.05)。2组TC及LDL-C分别比较,差异均无统计学意义(P>0.05)。2组中医证候分型及PASI分布情况组间比较,差异均无统计学意义(P>0.05)。但MS组湿热证、热毒证患者例数高于非MS组,差异均有统计学意义(P<0.05)。结论:银屑病患者伴发代谢综合征的发生率较高;伴有代谢综合征的银屑病患者年龄大、病程长,银屑病与代谢综合征有某些共同的发病基础。

Clinical Study on Psoriasis Vulgaris Complicated with Metabolic Syndrome

Objective: To retrospectively analyse the clinical characteristics of psoriasis vulgaris complicated with metabolic syndrome. Methods:A total of 206 cases of patients with psoriasis vulgaris were given retrospective analysis to record basic information and observed indexes including height,body mass,blood pressure,fasting blood glucose(FBG),triglyceride(TG), high-density lipoprotein cholesterol(HDL-C), total cholesterol(TC) and uric acid(UA);Chinese medicine syndrome types were given differentiation and treatment;severe areas and severity degree of lesions in patients with psoriasis were assessed by Psoriasis Area and Severity Index(PASI);the diagnostic criteria of metabolic syndrome was the one proclaimed by International Diabetes Federation in 2005. The ages,courses of disease,biochemical indexes,Chinese medicine syndrome types and PASI scores in the metabolic syndrome(MS) group and the without metabolic syndrome(nonMS) group were compared. Results:Among 206 cases of patients with psoriasis vulgaris,46 cases were accompanied with metabolic syndrome,accounting for 22.33%;160 cases were without metabolic syndrome,accounting for 77.67%. There was no significant difference being found in the course of disease between the two groups(P>0.05);there was significant difference being found in the ages between the two groups(P<0.05),and the comparison of the distribution of patients in each age stage between the two groups showed significant differences(P<0.05). Most of the patients were from 46 to 55 years old in the MS group,and from 36 to 45 years old in the non-MS group. Systolic blood pressure(SBP),diastolic blood pressure(DBP),FBG,TG,BMI and UA in the MS group were higher than those in the non-MS group,and HDL-C was lower, differences being significant(P<0.05). There was no significant difference being found in the comparison of total cholesterol and LDL-C between the two groups(P>0.05). There was no significant difference being found in the comparison of Chinese medicine syndrome types and PASI distribution between the two groups(P>0.05). However, the number of patients with damp heat syndrome and heat toxin syndrome in the MS group was higher than that in the non-MS group,differences being significant(P<0.05). Conclusion:The incidence of psoriasis vulgaris complicated with metabolic syndrome is relatively high,and these patients are older and have a longer course of disease. Psoriasis and metabolic syndrome have some common pathogenesis.