中华皮肤科杂志 ›› 2024, Vol. 57 ›› Issue (6): 510-515.doi: 10.35541/cjd.20230544

• 论著 • 上一篇    下一篇

慢性自发性荨麻疹伴与不伴血管性水肿患者131例临床特征回顾分析

王林霞    张立明    史美慧    高兴华    陈洪铎    肖汀   

  1. 中国医科大学附属第一医院皮肤科  卫健委免疫皮肤病学重点实验室  教育部免疫皮肤病学重点实验室  免疫性皮肤病诊治技术国家地方联合工程研究中心，沈阳  110001
  • 收稿日期:2023-09-20 修回日期:2024-03-20 发布日期:2024-06-03
  • 通讯作者: 肖汀;陈洪铎 E-mail:cmuxt@126.com; hongduochen@hotmail.com
  • 基金资助:
    国家临床重点专科建设项目（卫办医政函［2012］649）

Clinical features of 131 patients with chronic spontaneous urticaria accompanied by angioedema or not: a retrospective study

Wang Linxia, Zhang Liming, Shi Meihui, Gao Xinghua, Chen Hongduo, Xiao Ting   

  1. Department of Dermatology, the First Hospital of China Medical University, National Health Commission Key Laboratory of Immunodermatology, Key Laboratory of Immunodermatology of Ministry of Education, National Joint Engineering Research Center for Theranostics of Immunological Skin Diseases, Shenyang 110001, China
  • Received:2023-09-20 Revised:2024-03-20 Published:2024-06-03
  • Contact: Xiao Ting; Chen Hongduo E-mail:cmuxt@126.com; hongduochen@hotmail.com
  • Supported by:
    National Key Clinical Specialist Subject Construction Project（Health Office Medical Administration Letter ［2012］649）

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摘要： 【摘要】 目的 探讨伴血管性水肿（AE）的慢性自发性荨麻疹（CSU）患者的临床特点。方法 回顾性分析2019年1月至2021年12月于中国医科大学附属第一医院诊治的活动期成人CSU门诊患者的临床资料，包括性别、年龄、病程、血管性水肿伴发情况、日荨麻疹活动度评分、既往治疗史、既往史、家族史、实验室检查结果、疗效和不良反应。治疗方案参照2018版中国荨麻疹诊疗指南和2014版美国荨麻疹诊疗指南。统计分析采用Mann-Whitney U检验、两独立样本t检验、χ2检验、校正χ2检验及Fisher精确检验。结果 纳入CSU患者131例，男53例，女78例；初诊年龄（44.6 ± 13.3）岁，病程［M（Q1，Q3）］4.0（2.0，10.0）个月；伴AE组58例，无AE组73例。伴AE组病程［6.0（3.0，24.0）个月］显著长于无AE组［3.5（2.0， 6.0）个月，Z = -2.78，P = 0.005］，日荨麻疹活动度评分［5.0（3.0， 5.3）分］亦显著高于无AE组［4.0（3.0， 5.0）分，Z = -2.63，P = 0.008］。伴AE组用标准剂量第二代H1抗组胺药（sgAH）达到完全控制的CSU患者比例（8.6%，5/58）低于无AE组（24.7%，18/73），未控制比例（91.4%，53/58）高于无AE组（74.0%，54/73），差异有统计学意义（Z = -2.53，P = 0.011）；用sgAH单药加量或多种sgAH 2 ~ 4倍相当剂量达完全控制及未控制的患者比例、用4倍相当剂量sgAH联合非H1抗组胺药达完全控制及未控制的患者比例，两组间差异均无统计学意义（P > 0.05）。结论 与无AE的CSU患者相比，伴AE的CSU患者病程更长，疾病活动度更高，标准剂量sgAH治疗达到完全控制的患者比例更低，而未控制的患者比例更高。

关键词: 荨麻疹, 血管性水肿, 慢性自发性荨麻疹, 临床特点, 治疗结果

Abstract: 【Abstract】 Objective To investigate the clinical features of chronic spontaneous urticaria （CSU） patients with angioedema （AE）. Methods Clinical data were collected from adult outpatients with active CSU diagnosed and treated at the First Hospital of China Medical University from January 2019 to December 2021, and analyzed retrospectively. The data included gender, age, disease duration, the presence or absence of angioedema, urticaria activity score for one day, prior treatments, previous history, family history, laboratory test results, therapeutic effect, and adverse reactions. Their treatment regimens were based on the Chinese guidelines for the diagnosis and treatment of urticaria （2018） and the American guidelines for the diagnosis and management of urticaria （2014）. Statistical analysis was carried out by using Mann-Whitney U test, two-independent-sample t test, Chi-square test, corrected Chi-square test, and Fisher's exact test. Results A total of 131 CSU patients were collected, including 78 females and 53 males. Their age at the first visit was 44.6 ± 13.3 years, and the disease duration （M［Q1, Q3］） was 4.0 （2.0, 10.0） months. Among these CSU patients, there were 58 with AE and 73 without AE. The disease duration was significantly longer in the CSU patients with AE （6.0 ［3.0, 24.0］ months） than in those without AE （3.5 ［2.0, 6.0］ months; Z = -2.78, P = 0.005）. The urticaria activity score for one day was also significantly higher in the CSU patients with AE （5.0 ［3.0, 5.3］ points） than in those without AE （4.0 ［3.0, 5.0］ points; Z = -2.63, P = 0.008）. The CSU patients with AE showed a decreased proportion of patients completely controlled by licensed-dose second-generation H1-antihistamines （sgAHs） （8.6%, 5/58） compared with those without AE （24.7%, 18/73）, but an increased proportion of patients uncontrolled by licensed-dose sgAHs （91.4%, 53/58） compared with those without AE （74.0%, 54/73; Z = -2.53, P = 0.011）; there were no significant differences in the proportions of patients completely controlled or uncontrolled by updosed sgAHs alone or combinations of 2- to 4-fold equivalent-dose sgAHs, or in the proportions of patients completely controlled or uncontrolled by combination therapy with 4-fold equivalent-dose sgAHs and non-H1-antihistamines between the CSU patients with AE and those without AE （P > 0.05）. Conclusion Compared with the CSU patients without AE, the CSU patients with AE had a longer disease duration, higher disease activity, a lower proportion of patients completely controlled by licensed-dose sgAHs, and a higher proportion of patients uncontrolled by licensed-dose sgAHs.

Key words: Urticaria, Angioedema, Chronic spontaneous urticaria, Clinical features, Treatment outcome

引用本文

王林霞 张立明 史美慧 高兴华 陈洪铎 肖汀. 慢性自发性荨麻疹伴与不伴血管性水肿患者131例临床特征回顾分析[J]. 中华皮肤科杂志, 2024,57(6):510-515. doi:10.35541/cjd.20230544

Wang Linxia, Zhang Liming, Shi Meihui, Gao Xinghua, Chen Hongduo, Xiao Ting. Clinical features of 131 patients with chronic spontaneous urticaria accompanied by angioedema or not: a retrospective study[J]. Chinese Journal of Dermatology, 2024, 57(6): 510-515.doi:10.35541/cjd.20230544