斑贴试验在中老年手部湿疹患者中的诊断价值

The diagnostic value of patch test in middle-aged and elderly patients with hand eczema

中文关键词: 中老年  手部湿疹  斑贴试验  致敏原

英文关键词: middle-aged and elderly  hand eczema  patch test  allergen

中文摘要:

      目的 明确手部湿疹常见的致敏原及相关影响因素.方法 选取2013 年7 月—2023 年7 月于复旦大学附属华山医院皮肤科门诊手部湿疹患者368 例,回顾性收集其病史信息及斑贴试验资料,并对数据进行描述性分析及卡方检验等统计分析.结果 368 例患者中女性患者239 例,男性患者129 例,年龄范围18～70 岁,青年组(18～44 岁)276 例,中老年组(年龄≥45 岁)92 例.368 例手部湿疹患者中共有335 例斑贴试验呈阳性,总阳性率为91.03%,而2 组阳性率差异无统计学意义(P =0.114).在检测的26 种致敏原中,阳性率最高的致敏原为硫柳汞,其次分别为氯化钴、重铬酸钾、硫酸镍和卡巴混合物.中老年组硫柳汞和硫酸镍的阳性率显著低于青年组(P＜0.05),二甲苯的阳性率显著高于青年组(P＜0.05).在不同季节斑贴试验结果分析中,夏季斑贴试验的阳性率最高(P＜0.05).结论 手部湿疹患者尤其是中老年患者应完善斑贴试验检查,明确致敏因素并避免接触.

英文摘要:

      Objective To identify common allergens and influencing factors of hand eczema.Methods A total of 368 outpatient patients who were diagnosed as hand eczema and underwent patch tests in Department of Dermatology,Huashan Hos-pital,Fudan University from July 2013 to July 2023 were enrolled.Their medical history and patch test data were collected and reviewed retrospectively.The data was analyzed by descriptive analysis and Chi-square test.Results Among 368 patients,239 were female and 129 were male,with an age range of 18-70 years old.There were 276 ones in the youth group(18-44 years old)and 92 ones in the middle-aged and elderly group(aged≥45 years old).In 368 patients with hand eczema,335 ca-ses were positive by patch test,with a total positive rate of 91.03%.There was no statistically significant difference in the posi-tive rates between the two groups(P =0.114).Among the 26 allergens detected,the allergen with the highest positive rate was thiomersal,followed by cobalt chloride,potassium dichromate,nickel sulfate,and carbamate mixture.The positive rates of thi-omersal and nickel sulfate in the middle-aged and elderly groups were significantly lower than those in the young group(P＜0.05),and the positive rate of dimethyl benzene was significantly higher than that in the young group(P＜0.05).In the analysis of patch test results in different seasons,the positive rate of patch test in summer was the highest(P＜0.05).Conclusion Pa-tients with hand eczema,especially middle-aged and elderly patients,should take the patch test to identify their allergens and avoid them.