2015-2019年北京市某儿童医院儿童特应性皮炎的临床特征及治疗现况研究

Analysis of clinical characteristics and treatment status of atopic dermatitis in a children′s hospital in Beijing from 2015 to 2019

分析2015—2019年北京市某儿童医院门诊就诊特应性皮炎(AD)患儿的临床特点和治疗现状。本研究采用横断面研究方法,对2015年4月至2019年4月在首都医科大学附属北京儿童医院皮肤科门诊就诊的AD患儿资料进行回顾性分析,共纳入1926例0~17.5岁居住在北京及其周边地区的AD患儿,记录一般情况、AD疾病严重程度及皮损分布情况、AD的临床特征和疾病严重程度、AD发病的相关影响因素、AD疾病转归及治疗现况。采用SAS 9.4、SPSS19.0和R软件进行数据处理,采用描述性统计分析、卡方检验、方差分析及对应分析等方法进行统计分析。结果显示,本研究纳入的AD患者,男∶女比例为1.4∶1;有79.0%(1522/1926)、86.1%(1658/1926)、91.3%(1758/1926)和97.3%(1907/1926)在6月龄、1岁、2岁和5岁起病;轻度占13.2%(255/1926)(SCORAD评分0~24)、中度50.1%(965/1926)(SCORAD评分25~50)和重度36.7%(706/1926)(SCORAD评分>50),重度患儿年龄小于轻度和中度患儿;面部、头部、躯干和下肢为中重度AD常见起病部位,手、足、耳部为重度AD好发部位;温度变化、热水因素、精神情绪和春冬季是诱发AD加重的常见因素;有35.2%(678/1926)处于症状加重状态,61.8%(1191/1926)处于症状持续存在状态;洗澡越频繁,AD患儿的疾病严重程度越轻(χ^(2)=29.791,P<0.001);有28.0%(520/1856)的AD患儿从没有润肤习惯,与AD疾病严重程度具有相关性(χ^(2)=15.908,P<0.05);中、重度AD患儿联合用药的比例显著高于轻度AD患儿。综上,2015—2019年期间首都医科大学附属北京儿童医院皮肤科专科门诊就诊的AD患儿多在5岁内发病,疾病严重程度以中重度为主,大部分患者病情控制不佳,传统治疗方案存在局限性,识别儿童AD的临床特征和治疗现状,有助于开展更具有针对性的预防和管理工作。

To analyze the clinical characteristics and treatment status of atopic dermatitis(AD)in children in the outpatient department of a children′s hospital in Beijing from 2015 to 2019.This study used a cross-sectional study method to retrospectively analyze the data of AD patients who visited the Dermatology outpatient department of Beijing Children′s Hospital,Capital Medical University,from April 2015 to April 2019.A total of 1926 AD patients aged 0-17.5 years old living in Beijing and its surrounding areas were included,and the general situation,severity and distribution of AD disease,clinical characteristics and severity of AD,relevant influencing factors of AD onset,AD disease prognosis and treatment status were recorded.SAS 9.4,SPSS19.0,and R software were used for data processing,and descriptive statistical analysis,Chi-square test,Analysis of Variance,and correspondence analysis were used for statistical analysis.The results showed that the male to female ratio of AD patients in children included in this study was 1.4∶1;79.0%(1522/1926),86.1%(1658/1926),91.3%(1758/1926),and 97.3%(1907/1926)of AD onset at the age of 6 months,1 year,2 years,and 5 years,respectively;mild of AD patients accounted for 13.2%(255/1926)(SCORAD score 0-24),moderate of AD patients accounted for 50.1%(965/1926)(SCORAD score 25-50),and severe of AD patients accounted for 36.7%(706/1926)(SCORAD score>50).The age of severe AD patients were younger than mild and moderate AD patients.The face,head,trunk,and lower limbs were common areas of onset for moderate to severe AD,while the hands,feet,and ears were common areas of onset for severe AD patients.Temperature changes,hot water factors,mental and emotional states,and spring and winter were the main aggravation factors of AD;35.2%(678/1926)aggravated and 61.8%(1191/1926)persistent.The more frequent bathing,the less severity of AD disease(χ^(2)=29.791,P<0.001);28.0%(520/1856)of AD patients have no moisturizing habits,which were correlated with the severity of AD disease(χ^(2)=15.908,P<0.05);the proportion of combined treatment medications in children with moderate to severe AD was significantly higher than mild AD patients.In conclusion,the patients with AD who went to specialist clinics were mainly moderate to severe patients and developed disease before the age of 5 years from 2015 to 2019.The severity of AD were mainly moderate to severe,and most of these patients had poor disease control.Traditional treatment plans had limitations.Identifying the clinical characteristics and treatment status of childhood AD would help us to carry out more targeted prevention and management work.