儿童白癜风预后评估的临床探讨

Clinical analysis of childhood vitiligo prognosis assessment

目的初步建立儿童白癜风临床特征与预后关系的评估模型,探讨影响患者预后的临床因素。方法通过文献检索建立儿童白癜风患者标准病历;收集儿童白癜风患者临床资料;治疗方案采用中西医结合治疗,包括口服中药、微量元素、维生素,联合PUVA光化学疗法。结果经中西医结合治疗,150处皮损中痊愈36处,显效32处,有效30处,无效52处,痊愈率为24%,显效率为21%,有效率为20%,无效率为35%,总有效率为65%;PUVA照射时间、皮损部位、皮损毛发颜色、皮损面积和疗程规范情况为影响因子,对疗效具有显著性影响(P<0.05),应被纳入到回归模型中参与建立模型。结论中西医结合治疗儿童白癜风,具有良好的临床效果,总有效率达65%;PUVA照射时间、皮损部位、皮损毛发颜色、皮损面积和疗程规范情况对儿童白癜风预后评估影响显著;初步建立儿童白癜风评估预后模型。

Objective To establish a model for evalution of the correlations between the clinical characteristics and prognosis of childhood vitiligo and to use the model to predict the skin lesion prognosis of such patients with given survey information. Methods Data on skin lesions were researched and a complete medical history of each patient was established through literature search. Information on clinical characteristics of childhood vitiligo was collected. The therapeutic program was a combination of TCM and western medicine, involving Chinese herbal medicine, oral microelements and vitamins combined with PUVA photochemotherapy. Results In this research, 60 patients were admitted and no one dropped out. A total of 150 skin lesions were observed. After integrative medicine therapy, 24%of the cases （36 skin lesions） were cured, 21% （21 skin lesions） were markedly effective, 20% （30 skin lesions） were effective and 35% （52 skin lesions） were invalid. The overall effective rate was 65%. PUVA exposure time, skin lesion position, white hair around skin lesions, areas of the skin lesion and treatment specifications were considered impact factors （P〈0.05） and incorporated into the regression model. Conclusion The efficacy of integrative medicine therapy is significant, the overall effeetive rate was 65%. This research shows that PUVA exposure time, skin lesion position, white hair around skin lesions, areas of the skin lesion and treatment specifications are of great significance in predicting the prognosis of childhood vitiligo.