中国三级医院成人特应性皮炎的患病率及临床特征
Prevalence and clinical features of adult atopic dermatitis in tertiary hospitals of China.
作者信息
Wang Xin, Shi Xiao-Dong, Li Lin-Feng, Zhou Ping, Shen Yi-Wei, Song Qing-Kun
机构信息
Department of Dermatology, Beijing Friendship Hospital, Capital Medical University Department of Dermatology, Beijing Shijitan Hospital, Capital Medical University Market Research Department, China Telecom Corporation Limited Beijing Research Institute, Beijing Future Science Park, Beijing, China.
出版信息
Medicine (Baltimore). 2017 Mar;96(11):e6317. doi: 10.1097/MD.0000000000006317.
The prevalence of atopic dermatitis (AD) has increased substantially. Previous studies have focused mostly on pediatric patients, while epidemiological investigation on adult AD has been very limited.The aim of this study was to determine the prevalence and clinical features of adult AD in outpatients with dermatitis and eczema in China mainland.A multicenter cross-sectional study was conducted among outpatients with eczema or dermatitis from 39 tertiary hospitals of 15 provinces in China from July 1 to September 30, 2014.Of 8758 patients, 407 were adult AD. Compared with adults with other types of dermatitis, the mean age (41.8 ± 14.3 vs 42.04 ± 15.38 years, P < 0.05) and onset age (35.2 ± 11.2 vs 39.2 ± 14.0 years, P < 0.001) of adult AD were younger, and mean disease duration was longer (5.3 ± 7.1 vs 2.8 ± 4.9 years, P < 0.001). About 53.3% adult AD involved 3 or more body locations, higher than adults with other types of dermatitis (34.4%, P < 0.001), but lower than those with pediatric and adolescent AD (73.8%, P < 0.001). History of asthma (19.2% vs 6.9%, P < 0.001) or allergic conjunctivitis (21.9% vs 14.9%, P < 0.05) was more common in adult AD than pediatric/adolescent AD. Suspected bacterial infection was more frequently in adult AD than adults with other types of dermatitis (24.3% vs 14.6%, P < 0.001) and pediatric/adolescent AD (24.3% vs 14.9%, P < 0.001). More severe itching was observed in 31.4% of adult AD, higher than that of adults with other types of dermatitis (15.4%, P < 0.001), whereas similar to that of pediatric/adolescent AD (28.7%, P > 0.05). The highest (8.7%) and lowest prevalence (3.7%) of adult AD were in 25°N to 30°N and 35°N to 40°N latitude region.A substantial part of adult outpatients with eczema or dermatitis is adult AD. Middle age, more body location involvement, more suspected bacterial infection, and severe itching are the main clinical feathers of adult AD. Geographical environment and economic situation work in synergy to adult AD.
特应性皮炎（AD）的患病率已大幅上升。以往的研究主要集中在儿科患者，而对成人AD的流行病学调查非常有限。本研究的目的是确定中国大陆皮炎和湿疹门诊患者中成人AD的患病率及临床特征。2014年7月1日至9月30日，在中国15个省份的39家三级医院对湿疹或皮炎门诊患者进行了一项多中心横断面研究。在8758例患者中，407例为成人AD。与其他类型皮炎的成人相比，成人AD的平均年龄（41.8±14.3岁 vs 42.04±15.38岁，P<0.05）和发病年龄（35.2±11.2岁 vs 39.2±14.0岁，P<0.001）更小，平均病程更长（5.3±7.1年 vs 2.8±4.9年，P<0.001）。约53.3%的成人AD累及3个或更多身体部位，高于其他类型皮炎的成人（34.4%，P<0.001），但低于儿童和青少年AD（73.8%，P<0.001）。哮喘病史（19.2% vs 6.9%，P<0.001）或过敏性结膜炎病史（21.9% vs 14.9%，P<0.05）在成人AD中比儿童/青少年AD更常见。成人AD中疑似细菌感染的频率高于其他类型皮炎的成人（24.3% vs 14.6%，P<0.001）和儿童/青少年AD（24.3% vs 14.9%，P<0.001）。31.4%的成人AD观察到更严重的瘙痒，高于其他类型皮炎的成人（15.4%，P<0.001），而与儿童/青少年AD相似（28.7%，P>0.05）。成人AD患病率最高（8.7%）和最低（3.7%）的地区分别是北纬25°至30°和北纬35°至40°地区。相当一部分湿疹或皮炎的成人门诊患者为成人AD。中年、更多身体部位受累、更多疑似细菌感染和严重瘙痒是成人AD的主要临床特征。地理环境和经济状况对成人AD有协同作用。
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