中华皮肤科杂志 ›› 2008, Vol. 41 ›› Issue (3): 166-169.

• 论著 • 上一篇    下一篇

青春期后女性痤疮与慢性应激及雄激素水平的相关性研究

王琳 谢红付 李吉 等   

  1. 深圳口岸医院六楼 长沙中南大学湘雅医院皮肤科 长沙中南大学湘雅医院皮肤科
  • 收稿日期:2007-04-06 修回日期:2007-11-07 发布日期:2008-03-15
  • 通讯作者: 王琳 E-mail:aristinal0515@yahoo.com.cn

  

  • Received:2007-04-06 Revised:2007-11-07 Published:2008-03-15

摘要: 目的 研究青春期后女性痤疮患者的皮损总数、严重程度、生活质量与慢性应激、肾上腺源性雄激素水平的相关性。方法 100例26 ~ 45岁女性受试者(50例痤疮患者和50例正常对照)被纳入到该研究。通过单次血清采样,用放射免疫的方法测定受试者血清硫酸脱氢表雄酮(DHEAS)、皮质醇水平。同时用生活事件量表对受试者的慢性应激进行定性与定量;用皮肤病生活质量指数测定痤疮对患者生活的影响;用痤疮皮损计数法和痤疮综合分级系统记录患者皮损总数和严重程度。结果 病例组生活事件(总分值189.7 ± 36.5)、血清DHEAS(140 ± 30 μg/L)和皮质醇(348 ± 88 μg/L)水平均显著高于对照组(生活事件总分值104.3 ± 13.3、血清DHEAS 110 ± 17 μg/L、皮质醇142 ± 85 μg/L),两组比较,P 均 < 0.01。病例组的生活事件与血清DHEAS(r = 0.34,P < 0.05)、皮质醇(r = 0.44,P < 0.01)、痤疮皮损总数(r = 0.29,P < 0.05)呈显著正相关;DHEAS水平与痤疮皮损总数呈显著正相关(r = 0.54,P < 0.01)。病例组皮损总数、严重程度均与皮肤病生活质量指数有显著相关性(均为P < 0.01)。结论 青春期后女性痤疮的发病及皮损总数与慢性应激及其导致的肾上腺源性雄激素升高存在相关性。患者的皮肤病生活质量与皮损总数及严重程度相关。对于此期患者,除常规治疗之外需要对抗雄激素的治疗及心理治疗。

Abstract: Objective To investigate the relationship of lesion counts, severity and dermatology life quality with chronic stress and adrenal androgen level in postadolescent women with acne. Methods One hundred females, including 50 patients with acne and 50 normal controls, aged 26-45 years were recruited. Serum dehydroepiandrosterone sulfate (DHEAS) and glucocorticoid (GC) levels were determined by radioimmunoassay with a single serum sampling. Meanwhile, the chronic stress of each subject was evaluated by life events scale(LES), the impact of acne on patients life was measured by dermatology life quality index (DLQI), the lesions were counted, and severity was evaluated by global acne grading system (GAGS). Results The life event score, serum levels of DHEAS and GC were significantly higher in the patients than those in the controls (189.7 ± 36.5 vs. 104.3 ± 13.3, 140 ± 30 μg/L vs. 110 ± 17 μg/L, 348 ± 88 μg/L vs. 142 ± 85 μg/L, respectively, all P < 0.01). The life event score positively correlated with the serum levels of DHEAS and GC (r = 0.34, P < 0.05; r = 0.44, P < 0.01) as well as the lesion counts (r = 0.29, P < 0.05) in patients, and DHEAS level was also positively correlated with lesion counts (r = 0.54, P < 0.01). In addition, DLQI appeared to significantly correlate with lesion counts and severity (both P < 0.01). Conclusions The occurrence and lesion number of acne are correlated with chronic stress and chronic stress-induced increase of adrenal androgen level in postadolescent women. Hence, antiandrogen and mental therapy should be given to these patients besides routine treatment.