新型冠状病毒感染疫情对白癜风患者疾病管理的影响:一项横断面研究

Effects on the disease management of vitiligo patients during COVID-19 epidemic:a cross-sectional study

目的:调查新冠感染疫情大暴发期间白癜风患者的治疗方式和治疗疗效,以及白癜风患者对新冠感染疫情下疾病管理的认知和新冠疫苗对白癜风患者的影响。方法:应用横断面研究的方法,采取方便抽样的方式对白癜风患者开展基于网络的问卷调查研究,组间差异的比较采用卡方检验或Fisher确切概率法。结果:共纳入142例白癜风患者,男69例(48.6%),女73例(51.4%),平均年龄(36.1±10.9)岁。本次西安市疫情期间,患者的治疗方式较疫情暴发前未出现明显变化。94例(66.2%)的诊疗计划受到此次疫情的干扰。81例(57.0%)在疫情期间经历过中断原有治疗或停止用药至少一周。中断治疗组患者皮损进展或复发的比例(34.6%,28/81)较治疗未受影响组(16.4%,10/61)明显增高,差异有统计学意义(χ^(2)=12.228,P=0.005)。分别有7.9%(3/38)和10.5%(4/38)来自西安市的患者在本次疫情期间通过“线下外出”和“线上药店”购买治疗白癜风的相关药物。共有35例(28.9%)在接种疫苗一个月内出现白斑进展,其中有21例(60.0%,21/35)认为接种新冠疫苗会对其白癜风病情产生不利影响。结论:新冠感染疫情流行对白癜风患者疾病管理造成负面影响,建议皮肤科医生根据疫情变化结合患者病情做出最佳的治疗决策,并积极开展相关健康教育。

Objective:To investigate the treatment and therapeutic effects,as well as the cognition of vitiligo patients on disease management during the COVID-19 outbreak and the impact of the COVID-19 vaccine on vitiligo patients.Methods:A cross-sectional study was applied to conduct a web-based questionnaire study of vitiligo patients by convenience sampling,and differences between groups were compared using the chi-square test or Fisher's exact probability method.Results:Of the 142 participants in our study,69(48.6%)were males and 73(51.4%)were females,the average age was(36.1±10.9)years.The treatment of patients was the same as before the outbreak of COVID-19 in Xi'an.81 patients(57.0%)experienced an interruption of treatment or discontinuation of medication for at least one week during the epidemic period.Compared with the unaffected group(16.4%,10/61),the progression or relapse rate of lesions in the interrupted treatment group(34.6%,28/81)was significantly higher(χ^(2)=12.228,P=0.005).7.9%(3/38)and 10.5%(4/38)of patients from Xi'an purchased vitiligo-related drugs through“going out by themselves”and“online pharmacies”respectively.The depigmented macules enlarged in 35(28.9%)patients within one month after vaccination,and 21(60.0%)of them thought that the the COVID-19 vaccine aggravated the disease.Conclusion:The prevalence of COVID-19 affects the disease management of patients with vitiligo.It is recommended that dermatologists should make optimal treatment decisions according to the change of the epidemic situation and the patient's condition,and actively conduct relevant health education.