儿童特应性皮炎临床表现与特征分析

Clinical manifestations and characteristics of atopic dermatitis in children

目的 探讨儿童特应性皮炎(atopic dermatitis, AD)的临床表现与特征。方法 选取上海市儿童医院2018年10月至2021年10月收治的AD患儿237例为AD组,同期体检的健康儿童80例为对照组,统计分析患儿首次发病年龄、皮损分布、临床症状以及发病的影响因素。结果 AD组中首次发病年龄<1个月患儿者143例(60.34%),1~3个月患儿56例(2.11%),4~6个月患儿22例(9.28%),>6个月患儿16例(6.75%);<6个月、6~12个月,1~2岁患儿皮损主要累及头面部(94.74%、86.89%、86.79%)及颈部(67.11%、50.82%、26.42%),而3~6岁患儿皮损主要类及四肢屈侧(87.23%)(P<0.05);<6个月、6~12个月患儿症状主要表现为耳廓下裂隙(51.32%、40.98%)、鼻孔下裂隙(25.00%、26.23%)及慢性头皮脱屑(63.16%、57.38%);1~2岁、3~6岁患儿主要表现为白色糠疹(41.51%、55.32%)、毛周隆起(50.94%、61.70%)(P<0.05);Logistic回归分析显示,家族过敏史(OR=2.483)、居住地临近街道或公路(OR=1.822)、饲养宠物(OR=1.921)及接触毛绒玩具(OR=1.864)是儿童AD发病的独立危险因素(P<0.05)。结论 AD在不同年龄患儿中临床表现存在一定差异,其发病与遗传及居住环境等因素有关。

Objective To investigate the clinical manifestations and characteristics of atopic dermatitis(AD) in children.Methods A total of 237 children with AD admitted from Oct. 2018 to Oct. 2021 were selected as the AD group, and 80 healthy children who underwent physical examination during the same period were selected as the control group.The age of first onset, distribution of skin lesions, clinical symptoms and influencing factors of the onset were analyzed statistically.Results In the AD group, there were 143(60.34%) children with the age of first onset <1 months, 56(2.11%) children with the age of 1~3 months, 22(9.28%) children with the age of 4~6,and 16(6.75%) children with the age of first onset > 6 months.Skin lesions in children aged <6 months, 6~12 months, 1~2 years were mainly involved in the head and face(94.74%,86.89%,86.79%) and neck(67.11%,50.82%,26.42%),while skin lesions in children aged 3~6 years were mainly involved in flexion of limbs(87.23%)(P<0.05);The main symptoms of children <6 months and 6~12 months were subauricle fissure(51.32%,40.98%),subnostril fissure(25.00%,26.23%) and chronic scalp desquamate(63.16%,57.38%).The main manifestations in children aged 1~2 and 3~6 years were pityriasis alba(41.51%,55.32%) and perihair eminence(50.94%,61.70%)(P<0.05)(P<0.05).Logistic regression analysis showed that family history of allergy(OR=2.483),living near street OR highway(OR=1.822),keeping pets(OR=1.921) and exposure to plush toys(OR=1.864) were independent risk factors for children with AD(P<0.05).Conclusion The clinical manifestations of AD in children of different ages are different, and the incidence of AD is related to genetic factors and residential environment.