成年人银屑病严重程度与血清尿酸水平的关系研究

Relationship between severity of adult psoriasis and serum level of uric acid

目的探究成年人银屑病严重程度与血清尿酸(SUA)水平之间的关系,为银屑病患者临床病情管理提供参考。方法回顾性分析2018年9月至2023年3月于中日友好医院皮肤科确诊的银屑病患者154例,其中,轻度银屑病组18例,中度银屑病组76例,重度银屑病组60例。分析比较各组患者性别、年龄、病史、BMI以及生化检验结果等临床资料。使用logistic回归分析SUA水平与重度银屑病之间的关系,构建列线图预测发展为重度银屑病的风险,使用ROC曲线下面积和Hosmer-Lemeshow拟合优度检验分别对模型区分度和校准度进行评价。结果重度银屑病组病程在15年及以上的患者构成比显著高于中度银屑病组,SUA水平显著高于轻、中度银屑病组(P<0.05);与轻中度银屑病组相比,SUA水平(OR=1.005,95%CI 1.000~1.009)和病程(OR=3.175,95%CI 1.504~6.703)是重度银屑病的危险因素;通过构建的列线图可预测发展为重度银屑病的风险概率。结论SUA水平与重度银屑病的发生密切相关,构建临床预测模型对银屑病患者的病情管理具有一定参考价值。

Objective To study the correlation between severity of psoriasis in adults and serum uric acid(SUA)level,to provide a reference for the clinical management of psoriasis patients.Methods A total of 154 patients with psoriasis diagnosed in the Department of Dermatology,China-Japan Friendship Hospital from September 2018 to March 2023 were retrospectively analyzed.Among them,18 cases had mild psoriasis,76 cases had moderate psoriasis,and 60 cases had severe psoriasis.The data such as gender,age,medical history,BMI,and biochemical test results were collected.Logistic regression was used to analyze the relationship between SUA level and severe psoriasis.The nomogram was constructed to predict the risk of developing severe psoriasis.The area under the ROC curve and Hosmer-Lemeshow analysis were used to evaluate the model discrimination and calibration,respectively.Results The constituent ratio of patients with a disease course of 15 years or more in the severe psoriasis group was significantly higher than that in the moderate psoriasis group,and the SUA level was significantly higher than that in the mild and moderate psoriasis groups(P<0.05).Compared with mild to moderate psoriasis,SUA(OR=1.005,95%CI 1.000-1.009)and course of psoriasis(OR=3.175,95%CI 1.504-6.703)were risk factors for severe psoriasis.The risk probability of progression to severe psoriasis was predicted by the nomogram.Conclusions There is a significant relationship between SUA level and severe psoriasis,and constructing a clinical prediction model has certain reference value for the management of psoriasis patients.