中国银屑病患者中银屑病关节炎的患病率和特征

原文

译文

Prevalence and characteristics of psoriatic arthritis in Chinese patients with psoriasis

1. Q Yang^1,2,†,

2. L Qu^2,3,†,

3. H Tian^2,3,

4. Y Hu²,

5. J Peng²,

6. X Yu²,

7. C Yu²,

8. Z Pei²,

9. G Wang²,

10. B Shi²,

11. F Zhang²,

12. Y Zhang⁴,

13. F Zhang^1,2,3

Article first published online: 23 FEB 2011

Arthritis & Rheumatism DOI: 10.1111/j.1468-3083.2011.03985.x

Abstract

Background The prevalence and clinical characteristics of psoriatic arthritis (PsA) in patients with psoriasis vary widely in different countries and studies on Chinese population are rarely reported.

Objective The aim of this study was to evaluate the prevalence and clinical characteristics of PsA in a Chinese population of patients with psoriasis.

Methods A large cross-sectional observational study was conducted in our outpatient dermatology department and consecutive psoriatic patients were evaluated for PsA according to Classification of Psoriatic arthritis (CASPAR) criteria. Demographic and medical parameters were recorded.

Results Among 1928 patients with psoriasis, 112 patients (5.8%) had PsA, of which 92% was newly diagnosed. Oligoarthritis (48.2%) was the most common manifestation pattern, followed by spondylitis (26.8%), polyarthritis (19.6%) and classic distal interphalangeal (DIP) arthritis (5.4%). Enthesitis was present in 26.8% and dactylitis in 13.4% of the patients. Compared with patients without PsA, patients with PsA had more severe skin disease (mean PASI 9.7 vs. 6.0), higher frequency of nail changes (46.4% vs. 21.0%) and scalp involvement (90.2% vs. 76.4%).

Conclusion The findings are consistent with a low prevalence of PsA among patients with psoriasis in Asia and confirm a high percentage of undiagnosed cases with active arthritis among PsA patients in dermatologist’s office. Dermatologists should screen for PsA in their patients, especially those with risk characteristics and early signs.

中国银屑病患者中银屑病关节炎的患病率和特征

背景银屑病患者中银屑病关节炎(PsA)的患病率和临床特点在不同的国家有很大的差异, 而中国人群的研究鲜有报道。

目的本研究旨在评估中国银屑病患者中PsA的患病率和临床特点。

方法对我们皮肤科门诊连续的银屑病患者进行大型横贯面观察研究，按照银屑病关节炎（CASPAR）分类标准评价是否存在PsA。并记录人口学和临床参数。

结果1928例银屑病患者中，112例(5.8%)患者有银屑病关节炎，其中92%是新诊断的。寡关节炎（48.2%）是最常见的表现模式,其次是脊柱关节炎(26.8%),多关节炎(19.6%)和典型的远端指间(DIP)关节炎(5.4%)。附着点炎和趾炎的发生率分别为26.8%和13.4%。与没有PsA的患者相比， PsA患者皮肤疾病的严重程度 (平均PASI 9.7 vs. 6.0)、指甲改变(46.4% vs.21%)和头皮累及（90.2%vs. 76.4%）的比例都更高。

结论以上结果与亚洲银屑病患者中PsA患病率低相一致，并证实了皮肤病诊室中有活动性关节炎的PsA患者漏诊率较高。皮肤科医师应当对有高危因素和早期症状的银屑病患者是否存在PsA进行筛查。