有无甲损害的银屑病住院患者临床特征比较

Comparison of the clinical features in inpatients of psoriasis with or without nail damage

目的:分析银屑病住院患者中甲损害情况与一般资料、皮疹严重程度、治疗方案等关系。方法:收集弋矶山医院住院的银屑病患者病历资料,比较伴银屑病甲损害者与不伴银屑病甲损害者的临床特征。结果:与无甲损组相比,甲损组男性[69(85.2%)]、年龄>40岁的患者[58(71.6%)]、住院费用>10000元的患者[11(14.1%)]较多,并且关节病型银屑病、红皮病型银屑病[8(9.9%)、19(23.5%)]较多,以上比较差异均有统计学意义(P<0.001)。甲损组银屑病皮疹面积与严重程度指数(PASI)[14.9(10.8,26.5)]及系统应用免疫抑制剂/糖皮质激素的例数[35(43.2%)]较无甲损组高,差异有统计学意义(均P<0.01)。甲损组皮损初发部位为头颈部的比例[29(35.8%)]高于无甲损组[50(19.8%)],无甲损组初发部位为上肢[28(11.1%)]、下肢[48(19.0%)]的比例高于甲损组[4(4.9%)、9(11.1%)];且甲损组皮损常以头颈部面积最大,而无甲损组皮损常以躯干部面积最大。以上比较差异均有统计学意义(P<0.05)。结论:伴有甲损害的银屑病住院患者男性较多且红皮病型银屑病及关节病型银屑病较多,预后不佳,需加强治疗。

Objective:To analyze the relationship between nail psoriasis and general data,rash severity and treatment plan in hospitalized patients with psoriasis.Methods:Medical records were collected from patients with psoriasis treated on hospitalization basis in our hospital,and compared for the differences of clinical characteristics between the patients with and without nail involvement.Results:Compared with the group without nail involvement,the hospitalization expense exceeding 10000 RMB yuan was seen in 11 patients(14.1%)with nail damage,particularly in men(n=69;85.2%)and patients aged over 40 years(n=58;71.6%),and arthropathy-type psoriasis(n=8;9.9%)and erythroderma-type psoriasis(n=19;23.5%) were dominant.The difference was significant between groups(P<0.001).Psoriasis skin rash area and severity index(PASI)[14.9(10.8,26.5)]and the number(n=35;43.2%)of people who accepted systemic immunosuppressive agents/glucocorticoids were higher in the nail damage group than in those without nail involvement(all P<0.01).The proportion of initial site of skin damage at the head and neck was higher in the nail damage group than in the group without nail involvement(n=29;35.8%vs.n=50;19.8%),yet the proportion of initial site of skin damage at upper limbs and lower extremities was higher in the group without nail involvement than in the nail damage group(n=28;11.1%vs.n=48;19.0%;n=4;4.9%vs.n=9;11.1%,respectively).Larger skin damage commonly occurred at the head and neck in patients with nail involvement,and patients without nail involvement had larger skin damage at the trunk.The difference was significant(P<0.05).Conclusion:In the inpatients of psoriasis,erythroderma-type psoriasis and arthropathy-type psoriasis are more common in men with nail damage than in those without nail involvement.Certain difference exists in the initial site and the largest damaged skin size of the body between patients with and without nail involvement.Prognosis is poor in psoriasis patients with nail involvement,suggesting that this group of patients require intensive treatment.