毛发显微图像分析系统在雄激素性秃发疗效分析中的应用

The exploration of Trichoscan in assessing therapeutic efficacy of androgenetic alopecia

目的:通过毛发显微图像分析系统(Trichoscan)对421例雄激素性秃发(AGA)患者额顶部脱发区域进行毛发密度、终毛/毳毛比例测试,从而对患者病情评估及疗效进行分析。同时进行传统的全头照片拍摄并进行BASP分型和积分,从而比较2种方法的临床实用性和缺陷性。方法:收集2015年4月—2016年1月皮肤科毛发疾病门诊就诊的AGA患者。利用Trichoscan对患者额顶部脱发区域毛发进行密度、终毛/毳毛比例测试,同时拍摄全头照片,根据患者脱发情况进行BASP分型,根据其治疗时间进行分组,利用统计软件SPSS 20.0进行分析。结果:规范治疗的男性和女性AGA患者,其毛发密度数值在治疗2个月时便较治疗前明显增加,差异具有统计学意义。终毛/毳毛比例值在治疗后的变化基本无统计学差异。传统的全头照片在改良的BASP分型和积分下,治疗2个月后BASP积分数值变化很小,差异无统计学意义;男性患者在治疗4个月后BASP积分数值明显增加,具有统计学差异;女性患者治疗6个月后BASP积分数值的改变仍无统计学差异。结论:Trichoscan所测量的毛发密度数值的改变能在治疗早期显示出治疗疗效,具有高度的灵敏性,终毛/毳毛比例可以辅助判断AGA患者的毛发生长状况,这优于传统全头照片,且这种优势对女性AGA患者受益更大。Trichoscan在对AGA患者的诊断、病情评估、及疗效分析中具有良好的临床实用性。

Objective： To evaluate the disease status and therapeutic efficacy in 421 patients with androgenetic alopecia（AGA） using a Trichoscan to measure the hair density and the ratio of terminal to vellus hairs on the hair loss area of the frontal scalp. Meanwhile the feasibility and weakness of Trichoscan were compared with that of the basic and specific classification, and accu- mulated scores assessed on the global pictures of the hair loss area. Methods： From April of 2015 to January of 2016, outpa- tients with AGA were enrolled in this study. A Trichoscan was used to measure the hair density and the ratio of terminal to vellus hairs on the hair loss area of the frontal scalp. The global pictures of the hair loss area were used to determine the basic and specific classification, and accumulated scores. Patients were grouped according to the treatment time. Data were analyzed using SPSS 20.0 software. Results： After standard treatments for 2 months, the average hair density significantly increased in both male and female AGA patients, while the ratio of terminal to vellus hairs did not change significantly. Using the method of basic and specific classification, and accumulated scores, 2-month treatments did not change the accumulated scores. However, 4-month treatments significantly increased the accumulated scores in male AGA patients. In contrast, 6-month treatments only induced minor increase in the accumulated scores in female AGA patients. Conclusions： Trichoscan is sensitive to demonstrate the changes in hair density, an indicator of the therapeutic efficacy, in the early treatment. The ratio of terminal to vellus hairs is helpful to assess hair growth, particularly in female AGA patients. Trichosean is superior to the traditional method, which uses clinical pictures, in the diagnosis and evaluation of disease condition and therapeutic effect for AGA patients.