青春期后痤疮严重程度影响因素的调查分析

目的了解青春期后痤疮严重程度的主要影响因素。方法对187例患者进行问卷调查,部分患者进行血清性激素水平的检测,肾上腺和卵巢的B超检查,细菌培养及耐药性试验。结果男性、阳性家族史、油性皮肤、嗜食油腻者、经常便秘者、工作压力较大者、伴发脂溢性皮炎者的痤疮较严重;痤疮的严重程度随着年龄的增长而减轻(P<0.1)。62.5%(20/32)患者雄激素水平升高(P<0.05),6.49%(5/77)女患者合并了多囊卵巢。细菌培养的分离率由高到低依次为耐甲氧西林凝固酶阴性葡萄球菌(MRCNS)、表皮葡萄球菌、痤疮丙酸杆菌;需氧菌的耐药率由高到低依次为青霉素、红霉素、氯洁霉素……。结论多种因素影响着青春期后痤疮的严重程度;对于顽固难治的患者,尚需考虑多囊卵巢及多重耐药菌株存在的可能。

Investigation Analysis of the Effect Factors to Post-adolescent Acne Severity

Objective To explore the major effect factors in post-adolescent acne severity. Methods 187 subjects were surveyed, and some of them were done at least one laboratory investigations. Serum sex hormones levels were measured, and adrenal gland and ovaries were examined by ultrasound scanning. Samples from lesion were cultured in aerobic, and anaerobic conditions and drug resistant tests were conducted in aerobic germs. Results Patients who were one or several characters of male, family history, oily skin, greasiness food lovers, constipation, job-stress exacerbation and concomitant seborrheic dermatitis were more serious than the corresponding benchmark groups. And the acne severity would reduced with growing age(P<0.1). The levels of androgen in 62.5%(20/32) of patients elevated over the reference values(P<0.05). Polycystic ovaries were examined in 6.49%(5/77) of female patients. Methicillin-resistant coagulase-negative staphylococci (MRCNS) was the highest in the isolated germs, and it was followed by staphylococci epidermidis and propioni acne. The highest rates of drug resistance in aerobic germs were penicillin, and it was followed by erythromycin and clindamycin. Conclusion Many factors contributing to post-adolescent acne severity, and polycystic ovaries and resistant bacteria might consider as possible causes of stubborn acne.