中华皮肤科杂志 ›› 2016, Vol. 49 ›› Issue (12): 879-882.

• 研究报道 • 上一篇    下一篇

男性系统性硬化病21例临床特点分析

李变变1,张改连2,张莉芸3,高文琴3,许珂4,杨艳丽5,闫明4,郭乾育3,马丹3   

  1. 1. 山西医科大学研究生院
    2. 山西医科大学第二医院
    3. 太原 山西医科大学附属大医院风湿免疫科
    4. 山西医学科学院山西大医院
    5. 山西大医院
  • 收稿日期:2016-03-25 修回日期:2016-09-02 出版日期:2016-12-15 发布日期:2016-12-01
  • 通讯作者: 张改连 E-mail:zgl1118@163.com

Clinical analysis of 21 male patients with systemic sclerosis

Bian-Bian LI1, 3, 3,ke xu4,Yanli 5,ming YAN6, 3, 3   

  • Received:2016-03-25 Revised:2016-09-02 Online:2016-12-15 Published:2016-12-01

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摘要：

目的 回顾性分析男性系统性硬化病（SSc）患者的临床特点。方法 收集2011年11月至2015年7月于山西医科大学附属大医院住院及门诊收治并确诊的21例男性和56例女性SSc患者的临床资料、实验室检查及甲襞微循环图像。结果 男性SSc患者病程［24（12 ~ 60）个月］明显短于女性［48（25 ~ 120）个月］，且男女两组患者SSc亚型分布差异有统计学意义（χ2 = 10.940，P = 0.004），男性患者以弥漫性皮肤型为主，女性以局限性皮肤型为主。男性患者首发症状雷诺现象的比例显著低于女性患者，而皮肤紧硬比例又显著高于女性患者（均P < 0.05）。男性SSc患者心功能不全、肾脏受累发生比例及mRSS评分均高于女性，而女性患者雷诺现象表现更为突出，差异均有统计学意义（均P < 0.05）。女性患者抗核抗体阳性率（96.3%）高于男性患者（72.2%，P < 0.05）。男女甲襞微循环图像半定量分析显示，女性患者巨型管襻更多见，差异有统计学意义（P < 0.05）。结论 男性SSc患者病程短，进展快，以弥漫性皮肤型居多，心脏及肾脏损害多见，皮肤紧硬程度高于女性SSc。

Abstract:

Li Bianbian, Zhang Gailian, Zhang Liyun, Gao Wenqin, Xu Ke, Yang Yanli, Yan Ming, Guo Qianyu, Ma Dan Graduate School of Shanxi Medical University, Taiyuan 030001, China （Li BB）; Department of Rheumatology, Shanxi DaYi Hospital, Taiyuan 030032, China （Zhang GL, Zhang LY, Gao WQ, Xu K, Yang YL, Yan M, Guo QY, Ma D） Corresponding author: Zhang Gailian, Email: zgl1118@163.com 【Abstract】 Objective To retrospectively analyze clinical features of male patients with systemic sclerosis （SSc）. Methods Clinical data, laboratory findings and nailfold videocapillaroscopic （NVC） images were collected from 21 male and 56 female patients with SSc who visited Shanxi Dayi Hospital between November 2011 and July 2015. Results Male patients with SSc had significantly shorter disease duration than female patients （M ［P25 , P75］: 24［12, 60］ months vs. 48［25, 120］ months, P < 0.05）. There was a significant difference in subtype distribution of SSc between male and female patients （χ2 = 10.940, P = 0.004）, and most male patients suffered from diffuse cutaneous SSc （dcSSc）, while most female patients suffered from limited cutaneous SSc （lcSSc）. Raynaud′s phenomenon occurred less frequently as initial symptoms in male patients than in female patients, while the prevalence of skin hardening, cardiac dysfunction and renal involvement was higher in male patients than in female patients （all P < 0.05）. Male patients also had higher modified Rodnan skin scores （mRSS） than female patients, while Raynaud′s phenomenon occurred more frequently in female patients （both P < 0.05）. In addition, the positive rate of antinuclear antibodies was significantly higher in female patients than in male patients （96.3% vs. 72.2%, P < 0.05）. Semiquantitative analysis of NVC images showed that giant vascular loops were more common in female patients than in male patients （P < 0.05）. Conclusion Compared with female patients with SSc, male patients seem to have shorter disease duration, more rapid disease progression, higher prevalence of cardiac dysfunction, renal involvement and skin hardening, and are more likely to suffer from dcSSc.