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[腿部溃疡的首发表现:对1000例患者数据的分析]

[First manifestation of leg ulcers : Analysis of data from 1000 patients].

作者信息

Körber A, Jockenhöfer F, Sondermann W, Stoffels-Weindorf M, Dissemond J

机构信息

Klinik und Poliklinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Essen, Hufelandstr. 55, 45122, Essen, Deutschland.

出版信息

Hautarzt. 2017 Jun;68(6):483-491. doi: 10.1007/s00105-017-3950-3.

Abstract

BACKGROUND

More than 1 million people in Germany suffer from leg ulcers. The diagnosis leg ulcer summarizes many different etiologies. The therapy of leg ulcers is an interdisciplinary and interprofessional challenge. Early identification of the cause of the leg ulcer and initiation of a causal therapy are essential for healing.

OBJECTIVES

The aim of this study was to investigate the initial manifestation age of patients with causally associated leg ulcers. Afterwards we calculated the most common etiologies according to decade.

PATIENTS AND METHODS

A prospective database at the University Hospital Essen, dermatological wound care center, was used to identify patients with chronic leg ulcers between 2002 and 2014. Clinical data of 1000 patients with chronic leg ulcers were analyzed in this monocentric study.

RESULTS

A total of 29 different etiologies were differentiated. Approximately 70% of etiologies were of vascular origin, while 30% were rare causes. The count of different etiologies showed significant differences related to the onset and the occurrence in individual decades of life. In particular, nonvascular etiologies such as pyoderma gangrenosum or necrobiosis lipoidica are relatively more common in younger patients than in the aged.

CONCLUSION

Based on the findings of our study, it is possible to limit the underlying etiology on the basis of the age of first manifestation of the leg ulcer in order to make targeted diagnostics more effective. Thus, this information can help to optimize scarce time resources in daily practice and improve the prediction probability of leg ulcers.

摘要

背景

德国有超过100万人患有腿部溃疡。腿部溃疡这一诊断涵盖了许多不同的病因。腿部溃疡的治疗是一项跨学科和跨专业的挑战。早期识别腿部溃疡的病因并启动针对性治疗对于愈合至关重要。

目的

本研究的目的是调查与病因相关的腿部溃疡患者的初始发病年龄。之后,我们按十年计算了最常见的病因。

患者与方法

使用埃森大学医院皮肤科伤口护理中心的前瞻性数据库,确定2002年至2014年间患有慢性腿部溃疡的患者。在这项单中心研究中,对1000例慢性腿部溃疡患者的临床数据进行了分析。

结果

共区分出29种不同的病因。约70%的病因源于血管,而30%为罕见病因。不同病因的数量在个体生命的不同发病阶段和发生情况方面存在显著差异。特别是,坏疽性脓皮病或类脂质渐进性坏死等非血管性病因在年轻患者中相对比老年患者更常见。

结论

根据我们的研究结果,有可能根据腿部溃疡的首次发病年龄来限定潜在病因,以使针对性诊断更有效。因此,这些信息有助于在日常实践中优化稀缺的时间资源,并提高腿部溃疡的预测概率。

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