中国福建儿童和青少年特应性皮炎的临床特征、报告触发因素及共病模式：一项横断面研究

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中文摘要

背景： 来自中国南方的儿童特应性皮炎详细临床描述很少；现有的中国数据大多是模型化疾病负担估计或过敏原致敏的实验室系列。
方法： 这项单中心横断面研究纳入了47名年龄3.6-19.0岁、在中国福建省福州市一家三级皮肤科门诊符合英国工作组标准的儿童和青少年。触发因素、共病和家族史从常规记录中提取，并作为记录病史报告，而非经核实的诊断或患病率估计。严重程度通过体表面积（BSA）评估，评估皮肤科医生报告该评分是作为整体临床印象赋予的，而非根据特应性皮炎评分（SCORAD）组成部分计算，同时还使用患者导向湿疹测量（POEM）和儿童皮肤病生活质量指数。对两个源工作簿进行了复制伪影审计，审计标记的每个值均与原始临床记录核对。比例以Wilson 95%置信区间报告。
结果： 中位年龄为11.0岁（四分位距6.0-13.5岁）。屋尘螨是最常报告的触发因素（27/47，57.4%），其次是海鲜或甲壳类（40.4%）和潮湿环境（21.3%）；大多数参与者报告不止一种触发因素。未进行特异性IgE或皮肤点刺试验，因此这些仅为报告触发因素而非致敏。95.7%（95% CI 85.8-98.8）记录有过敏性疾病家族史，70.2%（56.0-81.3）记录有过敏性鼻炎；鼻炎这一数字部分构成纳入标准，家族史数字反映的是刻意宽泛的定义。记录哮喘罕见（1/44，2.3%），这是记录保存观察而非患病率估计。10份记录中有17个值是工作簿之间复制的残留，已根据原始记录更正。BSA与严重程度评分在各批次内相关（ρ=0.71和0.58），但合并后不相关（ρ=0.03），而POEM始终与BSA相关；因此严重程度按批次报告。
结论： 屋尘螨是最常报告的触发因素，过敏性鼻炎记录病史常见，且各批次内疾病以中度为主。每个数字都是反映一家诊所的确定方式和纳入标准的记录病史计数，而非人群患病率估计。这些是初步观察，需要在更大规模、前瞻性定义的多中心队列中确认。

英文摘要

BACKGROUND: Detailed clinical descriptions of paediatric atopic dermatitis from southern China are scarce; available Chinese data are largely modelled burden estimates or laboratory series of allergen sensitisation.
METHODS: This single-centre cross-sectional study included 47 children and adolescents aged 3.6-19.0 years meeting the UK Working Party criteria at a tertiary dermatology clinic in Fuzhou, Fujian Province, China. Triggers, comorbidities and family history were extracted from routine records and are reported as recorded histories, not as verified diagnoses or as prevalence estimates. Severity was assessed by body surface area (BSA), a score the assessing dermatologist reports having assigned as a global clinical impression rather than computed from the SCORing Atopic Dermatitis (SCORAD) components, as well as the Patient-Oriented Eczema Measure (POEM) and the Children's Dermatology Life Quality Index. The two source workbooks were audited for copying artefacts, and every value flagged by the audit was checked against the original clinic record. Proportions are reported with Wilson 95% confidence intervals.
RESULTS: Median age was 11.0 years (interquartile range 6.0-13.5 years). House dust mite was the most frequently reported trigger (27/47, 57.4%), followed by seafood or crustaceans (40.4%) and a damp environment (21.3%); most participants reported more than one trigger. No specific IgE or skin prick testing was performed, so these are reported triggers only and not sensitisations. A family history of allergic disease was recorded in 95.7% (95% CI 85.8-98.8) and allergic rhinitis in 70.2% (56.0-81.3); the rhinitis figure is partly constitutive of the enrolment criteria, and the family history figure reflects a deliberately broad definition. Recorded asthma was rare (1/44, 2.3%), a record-keeping observation rather than a prevalence estimate. Seventeen values in 10 records were residues of copying between the workbooks and were corrected against the original records. BSA and the severity score correlated within each batch (ρ = 0.71 and 0.58) but not when pooled (ρ = 0.03), whereas POEM correlated with BSA throughout; severity is therefore reported by batch.
CONCLUSION: House dust mite was the most frequently reported trigger, a recorded history of allergic rhinitis was common, and the disease was predominantly moderate within each batch. Every figure is a recorded-history count reflecting one clinic's ascertainment and its enrolment criteria, not a population prevalence estimate. These are preliminary observations requiring confirmation in larger, prospectively defined, multi-centre cohorts.