超声生物显微镜在正常人及银屑病患者皮肤研究中的应用

Application of ultrasound biomicroscopy on skin assessment in normal adults and psoriasis patients

目的探讨正常人皮肤及银屑病患者皮肤超声生物显微镜声像图特征及厚度测量方法。方法使用50 MHz探头的超声生物显微镜,对90例正常成人全身10个不同部位的皮肤以及40例银屑病患者皮肤进行声像观察及超声测厚。结果正常皮肤声像图表现为两条平行的强回声细带,中间为密集点状中等回声及稍强线样回声带。银屑病患者皮肤声像图表现为表皮、真皮明显增厚,结构紊乱,与正常皮肤界限清晰。测量的皮肤表皮厚度范围为(0.12±0.03)mm前臂内侧与(0.29±0.15)mm手掌之间,测量的皮肤真皮厚度范围在(1.18±0.32)mm手背与(1.55±0.21)mm胸骨旁之间。银屑病皮损表皮与真皮均较周围未累及皮肤增厚(P均<0.001),并且银屑病患者正常处皮肤真皮层厚度厚于正常人真皮层(P<0.001)。结论采用50 MHz的超声生物显微镜可以对正常人的皮肤结构(表皮、真皮、皮肤附属器)清晰地显示,并可以准确地测量真皮与表皮的厚度。为诊断和治疗银屑病提供依据。

Objective To investigate the features of normal and psoriasis skin on ultrasound biomicroscopy （UBM） and explore the method of thickness measurement. Methods Using 50 MHz ultrasound probe of biological microscope, ultrasonographic observation and ultrasonic thickness measurement were conducted in 90 normal adults and 40 psoriasis patients. Innormal patients, ultrasound evaluations were performed at 10 different parts of the body skin. Results On sonogram, the normal skin showed a ＂sandwich＂ structure with two parallel hyperechoic bands and the middle isoechoic dots and short liens. The sonograms of the psoriasis skin showed obviously thickened epidermis and dermis, disordered internal structure and clear boundary from adjacent normal skin. The range of the epidermis＇ thickness measurement was between the medial forearm （0.12±0.03）mm and the palm （0.29±0.15）mm. The range of dermal thickness measurement was between the back hand （1.18±0.32） mm and parastemal （1.55 ±0.21） mm. Psoriasis skin was thicker than the uninvolved skin （P〈 0.001）. And the dennis＇ thickness of uninvolved skin in psoriasis patients was thicker than that of the normal adults （P〈0.001）. Conclusion Normal adult＇s epidermis, dermis and skin appendages can be shown clearly using 50 MHz ultrasound biomicroscopy. And ultrasound biomicroscopy canaccurately measure the thickness of dermis and epidermis, which provides the basis for the diagnosis and treatment of psoriasis.