溃疡性结肠炎皮肤损害的相关因素研究

Study on related factors of skin lesions in ulcerative colitis

目的分析溃疡性结肠炎(UC)的皮肤损害状况,并探讨其发生的影响因素。方法选取2012年1月至2017年2月南阳市第二人民医院门诊就诊或病房收治的135例UC患者为研究对象,根据有无发生皮肤损害分为观察组和对照组,分析观察组患者的皮肤损害状况,比较两组的临床资料,采用多因素logistics回归分析UC患者发生皮肤损害的影响因素。结果全部患者中共有15例(11.1%)发生皮肤损害,其中结节性红斑(EN)4例,坏疽性脓皮病(PG)4例,银屑病2例,湿疹2例,鱼鳞病1例,玫瑰痤疮1例,天胞疮1例。皮肤损害的发病时间方面,11例患者在UC诊断后出现,4例患者在诊断时发现皮肤损害(包括EN2例、PG1例、湿疹1例),仅有1例EN是在UC诊断前已存在。观察组的慢性皮肤疾病家族史、病程≥10年、重度UC和重度活动期的发生率分别为20.0%、20.0%、60.0%、53.3%,显著高于对照组的(4.2%、3.3%、25.8%、22.5%),差异有统计学意义(P<0.05)。多因素logistic回归分析结果表明严重程度和临床分期是患者发生皮肤损害的独立影响因素(P<0.05)。结论有1/10的UC患者伴有皮肤损害,其中以EN和PG最为常见,皮损损害可出现在任何时期,包括UC的诊断之前、后或同时诊断,疾病严重程度和临床分期是UC患者发生皮肤损害的独立影响因素,病情越严重,发生皮肤损害风险越高。

Objective To analyze the skin lesions of ulcerative colitis(UC)and explore the related factors.Methods Totally 135 patients with UC from January 2012 to February 2017 were enrolled for the study and classified as observation group and control group according to whether skin lesions occurred or not.The status of skin lesions were analyzed in the observation group.The clinical data were compared between two groups.Multivariate logistics regression analysis was performed to investigate the related factors of skin lesions in patients with UC.Results In all patients,skin lesions occurred in 15 cases(11.1%),including 4 cases of erythema nodosum(EN),4 cases of pyoderma gangrenosum(PG),2 cases of psoriasis,2 cases of eczema,1 case of ichthyosis,1 case of Acne rosacea and 1 case of pemphigus.For the onset time of skin lesions,11 patients developed skin lesions after diagnosis of UC,4 patients developed at diagnosis(including 2 cases of EN,1 case of PG and 1 case of eczema)and 1 case developed EN before diagnosis of UC.The rate of family history of chronic skin disease,disease course≥10 years,severe UC and severe active phase in observation group were 20%,20%,60%and 53.3%,which were significantly higher than 4.2%,3.3%,25.8%and 22.5%in control group(P<0.05).Multivariate logistic regression analysis showed that severity and clinical stage were the independent related factors of skin lesions(P<0.05).Conclusion About 1/10 of patients with UC combined with skin lesions,in which EN and PG were most common.Skin lesions could occur concurrently,pre or post the diagnosis of UC.Disease severity and clinical stage were the independent related factors of skin lesions,and the more serious condition,the higher the risk of skin lesions.