皮肤疾病与脊髓损伤特征的临床研究

Clinical study on skin diseases and characteristics of spinal cord injury

目的 探讨脊髓损伤后皮肤疾病与脊髓损伤特征的关系。方法 采用回顾性研究,通过查询医院信息系统(HIS)及院内会诊记录,搜集2012年1月至2016年12月在中国康复研究中心北京博爱医院皮肤科会诊的554例脊髓损伤患者资料,统计一般人口学特征、脊髓损伤特征及皮肤病相关临床资料,并作统计学分析。结果 554例患者中,共检出皮肤疾病785例次,脂溢性皮炎100例(12. 74%),局部真菌感染71例(9. 04%),痤疮64例(8. 15%),毛囊炎56例(7. 13%),间擦疹53例(6. 75%),乏脂性湿疹49例(6. 24%)是脊髓损伤患者最常见的皮肤疾病。T6及以上节段损伤者296例,T7及以下节段损伤者258例,发现T6及以上节段损伤者中脂溢性皮炎、乏脂性湿疹和毛囊炎的占比高于T7及以下节段损伤者,差异有统计学意义(P<0.05)。完全性脊髓损伤274例,不完全性脊髓损伤207例,未分类73例,发现6种常见皮肤疾病的占比在脊髓完全性损伤和不完全性损伤组患者间差异无统计学意义(P> 0. 05)。脂溢性皮炎、痤疮、毛囊炎的皮疹发生于脊髓损伤平面上者的占比高于脊髓损伤平面下者,而乏脂性湿疹、间擦疹、真菌感染皮疹占比低于脊髓损伤平面下者,差异均有统计学意义(P<0.05)。结论 脊髓损伤患者是多种皮肤疾病的高发人群,皮肤疾病的发生与损伤节段相关、皮疹分布与损伤平面相关。

Objective To investigate the relationship between skin diseases and characteristics of patients with spinal cord injury(SCI).Methods Using a retrospective study,by querying the hospital information system(HIS)and in-hospital consultation records,data of 554 patients with SCI who were consulted by the Department of Dermatology,Beijing Boai Hospital,China Rehabilitation Research Center from January 2012 to December 2016 were collected.Their general demographic characteristics,clinical features of SCI and clinical data related to skin diseases were all recorded and statistically analyzed.Results Among the 554 patients,a total of 785 cases of skin diseases were detected,the most common dermatological finding was Seborrheic dermatitis 100 cases(12.74%),followed by local fungal infection 71 cases(9.04%),acne vulgaris 64 cases(8.15%),folliculitis 56 cases(7.13%),erythema intertrigo 53 cases(6.75%),asteatotic eczema 49 cases(6.24%).There were 296 cases with segmental injury at T_(6) and above,and 258 cases with segmental injury at T_(7) and below.The proportions of seborrheic dermatitis,hypolipidemic eczema and folliculitis in patients with segmental injury at T_(6) and above were higher than those with segmental injury at T_(7) and below,and the differences were statistically significant(P<0.05).There were 274 cases of complete SCI,207 cases of incomplete SCI,and 73 cases of unclassified SCI.It was found that the proportion of 6 common skin diseases was not significantly different between patients with complete SCI and incomplete SCI(P>0.05).The proportions of seborrheic dermatitis,acne and folliculitis rashes on the level of SCI were higher than those below the level of SCI,while the proportions of asteatotic eczema,erythema intertrigo and local fungal infection were lower than those below the level of SCI,and the differences were statistically significant(P<0.05).Conclusion Patients with SCI have a high incidence of various dermatological findings.The morbidity of skin diseases is related to the neurologically SCI segment,and the occurrence of lesion is related to the neurologically SCI level.