Analysis Of Social And Psychological Factors In Patients With Chronic Urticaria And Related Laboratory Study

Objective:Chronic urticaria, one of the most common skin disorders. It is a common and extremely distressing dermatological disease causing severe impairment in many facets of everyday life. However it still remains as a major health problem in terms of etiology and pathogenesis. We conducted a survey to study the feature of negative emotion, medical coping style and stress life events of the patients suffering from chronic urticaria. To detect the serum activity of diamine oxidase and the total serum IgE levels in chronic urticaria, so as to explore its significance in the pathogenesis of chronic urticaria and help the clinical treatment.Methods:Choose 68 patients suffering from chronic urticaria and 54 normal control from April 2010 to November 2010 in Tianjin Changzheng Hospital. In brief, the sex structure and age differences have no statistical difference, which proved comparability. CU patients and the healthy control group were investigated with Self-Rating Anxiety Scale, Self-Rating Depression Scale, Life Event Scale, Medical Coping Modes Questionnaire and urticaria activity score, at the same time quantify the score. Serum diamine oxidase activity and the total serum IgE levels were determined by spectrophotometry and Enzyme-linked immunosorbent assay. The diamine oxidase activity and the urticaria severity were compared by using linear correlation. The experimental results were analyzed by SPSS17.0.Results:1. The SAS and SDS scores were significantly higher in the patients suffering from CU than the healthy control group (p<0.01). Female SAS score was significantly higher than the male (p<0.05). Patients of different ages between SDS score were significantly (p<0.05),31-45 years old patients' SDS score was significantly higher than that of 18-30 years old patients'(p<0.05). Different education levels in patients with SAS and SDS scores were significantly different (p<0.01), the highest level of SDS scores was the patients who have junior middle school record, the second was the patients who have specialized middle school or high school record, both of them were significantly higher than those of junior college or undergraduate groups (p<0.01), junior college or undergraduate groups of SAS scores in patients was significantly lower than the others groups (p<0.01). SDS scores were significantly higher in anti-histamine-controllable individuals than those uncontrollable (p<0.01).2. LES-negative event score and LES-total event score were significantly higher in the patients suffering from chronic urticaria than those of healthy controls(p<0.01)3. Female MCMQ-avoid score and MCMQ-submit score were significantly higher than that of male(p<0.05).31-45 years old patients'MCMQ-face score was significantly higher than 46-60 years old patients'(p<0.05). MCMQ- face score of patients whose course of disease was 1-2 years was significantly hinger than those of 0.5-1 year (p<0.05). Different education levels in patients with MCMQ-face score was significantly different (p<0.05).4. The serum diamine oxidase activity in 1 hour,1.5 hour and 3 hours was lower than that of healthy control. There were significant differences in the serum activity of diamine oxidase and the total serum IgE levels between the two groups (P<0.01). The correlation between the activity and the urticaria severity was significant (P<0.05). When the serum total IgE≥175IU/mL, its correlate with disease severity (P<0.05).Conclusion:1. The severity of anxiety and depression were higher in the patients suffering from chronic urticaria than that of the healthy controls. It was different that the severity of anxiety and depression which the patients who suffering from chronic urticaria with different sex, age, education background.2. The patients suffering from chronic urticaria had encounterd more life events, especial negative life events than that of healthy persons.3. It was different that the medical coping modes which the patients who suffering from chronic urticaria with different sex, age and course of disease. This is indicated that CU patients should be given personalized treatment and related psychological counseling.4. The high serum IgE level and decreased DAO activity indicated that the change of DAO should be implicated with persistence of wheals in CU individuals due to delayed histamine degradation, and tIgE might be implicated with CU severity.