特应性皮炎夜间瘙痒程度的定量化研究

Quantitative Pruritus Using Actigraphy in Atopic Dermatitis Patients at Night

目的搔抓动作表现为手腕的加速度变化,采用加速度记录仪以手表形式佩戴于利侧手腕客观定量化评价特应性皮炎(atopic dermatitis,AD)瘙痒程度。方法健康志愿者与AD患者连续佩戴加速度记录仪记录手腕的加速度变化,设定ZCM模式第13型Mini-Motionlogger作为分析参数。为排除非瘙痒引起的干扰,采用夜间睡眠期的变量作为分析对象。评价治疗前后湿疹面积及严重度指数评分(eczema area and severity index,EASI)、视觉模拟评分(visual analogue scale,VAS)值变化,观察平均活动量(night activity,NA)和瘙痒时间占总睡眠时间百分比(the percent of itching time,PIT)的变化。并评价三者与皮损EASI评分间的相关性。结果 AD患者夜间睡眠时活动量较健康受试者更为频密。AD患者治疗前后NA的前后差值(△)与EASI评分的前后差值(△)相关性较低(P>0.05,r=0.42);VAS评分的前后差值与EASI评分的前后差值几乎没有线性关系(P>0.05,r=0.34);而PIT的前后差值与EASI评分的前后差值则呈直线相关(P<0.05,r=0.75)。结论本研究以健康人的夜间活动量作为基础阈值,计算PIT值,将非瘙痒引起的因素尽可能降低,取得了较好的效果。以PIT值作为分析指标,可取得AD患者夜间搔抓行为相对准确的定量。PIT值与EASI有较高的相关性。

Objectlve Scratching action performance wrists＂ acceleration changes used actigraphy in the form of watches and wore on the wrist to evaluate objective and quantitative pruritus of atopic dermatitis, AD. Methods Heahhy volunteers and patients with AD continuous wore actigraphies to record the acceleration changes, ZCM mode setting with section-13 type Mini-Motionlogger, as analysis parameters. In order to exclude non-itching interference, used nighttime sleeping variables for analysis.Evaluated before and after the treatment on EASI, visual analog scale,VAS changes, observed night activity, NA, and the percentage of itching time, PIT changes. In addition to analyze correlation between 3 factors and EASI lesions. Results Patients with AD are more frequently scratching than healthy volunteers. The correlation between the evaluation of patients with AD＇s before and after the treatment （ △ ）and the evaluation of EASI （ △ ）is low （P〉 0.05, r=0.42） ; the evaluation of VAS and EASI has no linear relationship （P 〉0.05, r=0.34） ; but the correlation between the evaluation of PIT＇s before and after treatment and the evaluation EASFs before and after treatment is a linear relationship（P 〈 0.05, r=0.75 ）. Conclusion In this research, healthy people as a basis for nocturnal activity as the threshold to calculate PIT, reduced non-itching factors as low as possible, and achieved reliable result. PIT as the analysis indicators to obtain accurate AD patients＂ nocturnal scratching behaviors quantitative. PIT values have better correlation with EASI（P〈0.05, r=0.75 ）.