超声生物显微镜在不同时期银屑病患者皮肤中的应用

doi:10.3877/cma.j.issn.1672-6448.2016.04.006

目的

研究不同时期银屑病患者皮肤超声生物显微镜声像图表现，计算各个时期皮肤厚度值。

方法

选取2015年3月至2016年2月首都医科大学附属北京朝阳医院就诊的寻常型银屑病患者150例，其中进行期患者50例、静止期50例、退行期50例。应用超声生物显微镜观察并测量其表皮、真皮厚度，观察表皮与真皮之间低回声暗带的变化。

结果

银屑病患者皮肤声像图表现为表皮、真皮不同程度增厚，结构紊乱，其内皮肤附属器显示清晰。表皮与真皮之间的低回声暗带也有不同程度的变化。不同时期银屑病患者表皮、真皮、暗带厚度比较，差异具有统计学意义（F=169.239、26.899、37.902，P值均<0.01）。表皮厚度进行期与静止期、退行期比较，差异具有统计学意义（t=4.389、18.987，P值均<0.01），静止期与退行期比较差异有统计学意义（t=12.892，P<0.01）；真皮厚度进行期与静止期比较，差异无统计学意义（t=1.702，P>0.05），退行期与进行期、静止期比较，差异具有统计学意义（t=6.428、5.941，P值均<0.01）；低回声暗带厚度进行期与静止期、退行期比较，差异具有统计学意义（t=6.073、7.540，P值均<0.01），静止期与退行期比较，差异具有统计学意义（t=3.826，P<0.01）。

结论

超声生物显微镜图像特征不同，可观察银屑病患者表皮、真皮及中间暗带的结构变化，各个时期皮肤厚度不同。

关键词: 显微镜检查，声学, 银屑病, 表皮, 真皮, 超声检查

Objective

To investigate the skin sonogram of ultrasound biomicroscopy of psoriasis patients in different stages and calculate the skin thickness in each stage.

Methods

Totally 150 normal psoriasis patients who were treated in Capital Medical University Affiliate Beijing Chaoyang Hospital from March, 2015 to February, 2016 were included, of which 50 were in active stage, 50 were in resting stage and 50 were in regression stage. Ultrasound biomicroscopy was applied to observe and measure the thickness of epidermis and dermis, and also the change of low-echo dark band between epidermis and dermis.

Results

The epidermis and dermis showed thickened in different degrees. The structures showed disordered and skin appendages displayed clearly by the skin sonogram of ultrasound biomicroscopy of psoriasis patients. The low-echo dark band between epidermis and dermis changed in different degrees. The differences of thicknesses of epidermis, dermis and dark band in different stages of psoriasis patients were statistically significant (F=169.239, 26.899, 37.902, all P<0.01). Compared the epidermis thicknesses in active stage with those in resting and regression stage, the differences were statistically significant. (t=4.389, 18.987, all P<0.01). Compared the epidermis thicknesses in resting stage with that in regression stage, the differences were statistically significant (t=12.892, P<0.01). Compared dermis thicknesses in active stage with that in resting stage, the differences were not statistically significant (t=1.702, P>0.05). Compared the dermis thicknesses in regression stage with those in active and resting stage, the differences were statistically significant (t=6.428, 5.941, both P<0.01). Compared the low-echo dark band thicknesses in active stage with those in resting and regression stage, the differences were statistically significant (t=6.073, 7.540, both P<0.01). Compared the low-echo dark band thicknesses in resting stage with in regression stage, the differences was statistically significant (t=3.826, P<0.01).

Conclusion

Based on different sonogram of ultrasound biomicroscopy, we can observe the structure change of epidermis, dermis and dark band, and also the difference of skin thickness in different stages.

Key words: Biomicroscopy examination, Ultrasonics, Psoriasis, Epidermis, Dermis, Ultrasonography

图4 超声生物显微镜寻常型银屑病静止期四肢部皮损图像，表皮层（五角星）与真皮层（向上箭头）明显增厚，回声略减低；低回声层（六角星）可见，皮肤附属器（四角星）显示清晰，部分皮下脂肪层结构（向下箭头）

图7 图5患者皮肤（大圆处）超声生物显微镜图像，表皮、真皮层（向上箭头）与正常皮肤声像图一致，部分皮下脂肪层（向下箭头）显示，基底层显示不清

表1 银屑病患者不同时期皮肤表皮、真皮、低回声暗带厚度比较（±s，mm）

组别	例数	表皮厚度	真皮厚度	暗带厚度
进行期	50	0.28±0.03^a	1.92±0.30^b	0.23±0.06^c
静止期	50	0.25±0.03^d	1.83±0.20	0.17±0.04^f
退行期	50	0.17±0.03	1.56±0.26^e	0.13±0.08
F值	?	169.239	26.899	37.902
P值	?	<0.01	<0.01	<0.01

表1 银屑病患者不同时期皮肤表皮、真皮、低回声暗带厚度比较（±s，mm）

组别	例数	表皮厚度	真皮厚度	暗带厚度
进行期	50	0.28±0.03^a	1.92±0.30^b	0.23±0.06^c
静止期	50	0.25±0.03^d	1.83±0.20	0.17±0.04^f
退行期	50	0.17±0.03	1.56±0.26^e	0.13±0.08
F值	?	169.239	26.899	37.902
P值	?	<0.01	<0.01	<0.01

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Application of ultrasound biomicroscopy in the skin of psoriasis in different stages

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Application of ultrasound biomicroscopy in the skin of psoriasis in different stages