中华皮肤科杂志 ›› 2025, Vol. 58 ›› Issue (11): 1053-1058.doi: 10.35541/cjd.20250198

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关节病型银屑病疾病特征分析：基于530例患者队列的横断面研究

高靖雅1    王怡怡1    胡宏香1    彭茜雅1    杨闵2    张凌燕3    唐静4    肖月1    郝丹1    周兴丽1    闫薇1    李薇1   

  1. 1四川大学华西医院皮肤性病科，成都  610041；2四川大学华西医院风湿免疫科，成都  610041；3四川大学华西医院超声科，成都  610041；4四川大学华西医院放射科，成都  610041
  • 收稿日期:2025-04-10 修回日期:2025-09-08 发布日期:2025-11-03
  • 通讯作者: 李薇 E-mail:liwei476@wchscu.cn
  • 基金资助:
    国家自然科学基金（82304062）

Characteristics of psoriatic arthritis: a cross-sectional study based on a cohort of 530 patients

Gao Jingya1, Wang Yiyi1, Hu Hongxiang1, Peng Xiya1, Yang Min2, Zhang Lingyan3, Tang Jing4, Xiao Yue1, Hao Dan1, Zhou Xingli1, Yan Wei1, Li Wei1   

  1. 1Department of Dermatology and Venereology, West China Hospital, Sichuan University, Chengdu 610041, China; 2Department of Rheumatology and Immunology, West China Hospital, Sichuan University, Chengdu 610041, China; 3Department of Ultrasound, West China Hospital, Sichuan University, Chengdu 610041, China; 4Department of Radiology, West China Hospital, Sichuan University, Chengdu 610041, China
  • Received:2025-04-10 Revised:2025-09-08 Published:2025-11-03
  • Contact: Li Wei E-mail:liwei476@wchscu.cn
  • Supported by:
    National Natural Science Foundation of China（82304062）

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摘要： 【摘要】 目的 基于华西医院关节病型银屑病（PsA）队列资料，描述PsA患者的疾病特征，为临床医师诊治及制定评估策略提供依据。方法 本研究为横断面研究。对2020年4月2日至2025年1月21日于四川大学华西医院就诊的PsA患者进行描述性分析，包括人口学特征、临床表现、实验室及影像学检查和治疗方式。结果 共纳入530例PsA患者，男332例（62.6%），女198例（37.4%），年龄（44.1 ± 12.4）岁；452例（85.3%）患者皮损早于关节症状，两者间隔时间M（Q1，Q3）为8.0（3.0，15.0）年；319例（60.2%）患者超重或肥胖，合并脂肪肝188例（35.5%）。外周关节受累常见（485例，91.5%），其中，近端指间关节为压痛（172例，35.5%）和肿胀（119例，24.5%）最常累及的关节，超声检查发现的附着点炎例数（116例，23.9%）高于临床检查（82例，15.5%）；中轴关节受累者258例（48.7%），以骶髂关节最为常见（201例，77.9%）。治疗方面，确诊PsA前银屑病治疗以传统药物为主，确诊PsA后采用靶向治疗者提高至334例（63.0%），其中白细胞介素17抑制剂最多（140例，26.4%），其次为肿瘤坏死因子α抑制剂（106例，20.0%）与Janus激酶抑制剂（39例，7.4%）。结论 PsA患者多见于40岁以上男性，具有皮损先发、诊断延迟和伴发多种共病等特征。高频超声在早期识别外周关节附着点炎方面具有优势，脂肪肝、肥胖代谢疾病等共病管理需进一步关注。

关键词: 关节病型银屑病, 体征和症状, 超声检查, 横断面研究, 诊断, 治疗, 共病

Abstract: 【Abstract】 Objective To investigate disease characteristics of patients with psoriatic arthritis （PsA） based on the PsA cohort in West China Hospital, so as to provide a reference for clinicians in its diagnosis, treatment, and evaluation strategy formulation. Methods A cross-sectional study was carried out, and a descriptive analysis was conducted on clinical data from PsA patients who were treated at the Department of Dermatology, West China Hospital, Sichuan University between April 2, 2020, and January 21, 2025. Demographic characteristics, clinical manifestations, laboratory and imaging findings, and treatment modalities were analyzed. Results A total of 530 PsA patients were included, of whom 332 （62.6%） were males and 198 （37.4%） were females, with ages of 44.1 ± 12.4 years. Skin lesions preceded joint symptoms in 452 patients （85.3%）, with time intervals （M ［Q1, Q3］） of 8.0 （3.0, 15.0） years. Overweight or obesity was observed in 319 patients （60.2%）, and 188 （35.5%） had comorbid fatty liver. Peripheral joint involvement was common （485 cases, 91.5%）, with the proximal interphalangeal joints being most frequently affected by tenderness （172 cases, 35.5%） and swelling （119 cases, 24.5%）; the number of enthesitis cases identified by ultrasonography （116 cases, 23.9%） was significantly higher than that by clinical examination （82 cases, 15.5%）; axial joint involvement was observed in 258 patients （48.7%）, with the sacroiliac joints most commonly affected （201 cases, 77.9%）. Regarding treatment, conventional systemic drugs were predominant in the treatment of psoriasis prior to the diagnosis of PsA; after the diagnosis of PsA, the number of patients receiving targeted therapies increased to 334 （63.0%）, with interleukin-17 inhibitors being the most common （140 cases, 26.4%）, followed by tumor necrosis factor-α inhibitors （106 cases, 20.0%） and Janus kinase inhibitors （39 cases, 7.4%）. Conclusions PsA predominantly affects males over 40 years old and is characterized by preceding skin lesions, delayed diagnosis, and multiple comorbidities. High-frequency ultrasound has advantages in the early detection of peripheral enthesitis. Further attention is needed for managing comorbidities such as fatty liver and obesity-related metabolic conditions.

Key words: Arthritis, psoriatic, Signs and symptoms, Ultrasonography, Cross-sectional studies, Diagnosis, Therapy, Comorbidity

引用本文

高靖雅 王怡怡 胡宏香 彭茜雅 杨闵 张凌燕 唐静 肖月 郝丹 周兴丽 闫薇 李薇. 关节病型银屑病疾病特征分析：基于530例患者队列的横断面研究[J]. 中华皮肤科杂志, 2025,58(11):1053-1058. doi:10.35541/cjd.20250198

Gao Jingya, Wang Yiyi, Hu Hongxiang, Peng Xiya, Yang Min, Zhang Lingyan, Tang Jing, Xiao Yue, Hao Dan, Zhou Xingli, Yan Wei, Li Wei. Characteristics of psoriatic arthritis: a cross-sectional study based on a cohort of 530 patients[J]. Chinese Journal of Dermatology, 2025, 58(11): 1053-1058.doi:10.35541/cjd.20250198