中华皮肤科杂志
中華皮膚科雜誌
중화피부과잡지
Chinese Journal of Dermatology
2015年
4期
240-244
,共5页
栾超%陈浩%杨永红%姜祎群%刘毅%陈敏%王宝玺
欒超%陳浩%楊永紅%薑祎群%劉毅%陳敏%王寶璽
란초%진호%양영홍%강의군%류의%진민%왕보새
银屑病%T淋巴细胞%黑素细胞%CD8阳性T淋巴细胞%CD4阳性T淋巴细胞
銀屑病%T淋巴細胞%黑素細胞%CD8暘性T淋巴細胞%CD4暘性T淋巴細胞
은설병%T림파세포%흑소세포%CD8양성T림파세포%CD4양성T림파세포
Psoriasis%T-lymphocytes%Melanocytes%CD8-positive T-lymphocytes%CD4-positive T-lymphocytes
目的 研究银屑病患者皮肤中CD4+和CD8+T细胞与黑素细胞的关系和临床意义.方法 取29例进行期银屑病患者皮损和非皮损、5例消退期患者皮损和非皮损及6例健康人皮肤.免疫组化检测CD4+T细胞和CD8+T细胞的数量和分布,并对比基底层黑素细胞和色素颗粒情况.采用SPSS18.0软件进行统计分析,多组间比较采用单因素方差分析(ANOVA),两组间比较采用最小显著差异法(LSD),相关性分析采用Pearson检验.结果 银屑病患者皮损中每个高倍(×200)视野CD4+T细胞平均数(表皮5.29±4.66,真皮77.50±43.66)明显高于非皮损(表皮为0,真皮9.67±7.73),皮损与非皮损比较,均P＜ 0.05;而CD8+T细胞的数量(表皮7.83±6.27,真皮46.08±34.26)亦明显高于非皮损(表皮0.71±1.20,真皮5.54±4.43),皮损与非皮损比较,均P＜ 0.05.与健康对照皮肤相比,银屑病患者皮损中CD4+T细胞和CD8+T细胞均明显增多,差异有统计学意义(均P＜ 0.05).银屑病皮损处基底层黑素细胞数量(103.45±16.96)明显高于非皮损(43.62±14.20,P＜0.05)及健康人皮肤(P＜0.05),但色素颗粒阳性细胞比例(7.45％±3.86％)明显低于非皮损(43.10％±14.91％,P＜ 0.05)及健康人皮肤(P＜0.05).非皮损处CD8+T细胞、CD4+T细胞、黑素细胞数量及色素颗粒阳性细胞比例与健康人比较差异均无统计学意义.消退期皮损黑素细胞数量高于消退后白斑(P＜0.05),色素颗粒阳性细胞比例略低于消退后白斑,但差异无统计学意义;与健康人比较,消退期皮损黑素细胞数量高,而色素颗粒阳性细胞比例低,均有统计学差异(均P＜ 0.05),消退后白斑的黑素细胞数量与健康人比较差异无统计学意义,而色素颗粒阳性细胞比例降低(P＜0.05).进行期患者皮损中CD4+、CD8+T细胞数与黑素细胞数及色素颗粒阳性细胞比例均无相关性(均P＞ 0.05),而非皮损中CD4+、CD8+T细胞数与黑素细胞数呈正相关(r值分别为0.46和0.56,均P＜ 0.05),但与色素颗粒阳性细胞比例无明显相关性(P＞0.05).结论 在银屑病进行期皮损中,CD4+T细胞和CD8+T细胞明显增多,基底层黑素细胞数量增加,但色素颗粒明显减少;皮损消退后,黑素细胞数量及色素颗粒逐渐接近健康人水平.
目的 研究銀屑病患者皮膚中CD4+和CD8+T細胞與黑素細胞的關繫和臨床意義.方法 取29例進行期銀屑病患者皮損和非皮損、5例消退期患者皮損和非皮損及6例健康人皮膚.免疫組化檢測CD4+T細胞和CD8+T細胞的數量和分佈,併對比基底層黑素細胞和色素顆粒情況.採用SPSS18.0軟件進行統計分析,多組間比較採用單因素方差分析(ANOVA),兩組間比較採用最小顯著差異法(LSD),相關性分析採用Pearson檢驗.結果 銀屑病患者皮損中每箇高倍(×200)視野CD4+T細胞平均數(錶皮5.29±4.66,真皮77.50±43.66)明顯高于非皮損(錶皮為0,真皮9.67±7.73),皮損與非皮損比較,均P＜ 0.05;而CD8+T細胞的數量(錶皮7.83±6.27,真皮46.08±34.26)亦明顯高于非皮損(錶皮0.71±1.20,真皮5.54±4.43),皮損與非皮損比較,均P＜ 0.05.與健康對照皮膚相比,銀屑病患者皮損中CD4+T細胞和CD8+T細胞均明顯增多,差異有統計學意義(均P＜ 0.05).銀屑病皮損處基底層黑素細胞數量(103.45±16.96)明顯高于非皮損(43.62±14.20,P＜0.05)及健康人皮膚(P＜0.05),但色素顆粒暘性細胞比例(7.45％±3.86％)明顯低于非皮損(43.10％±14.91％,P＜ 0.05)及健康人皮膚(P＜0.05).非皮損處CD8+T細胞、CD4+T細胞、黑素細胞數量及色素顆粒暘性細胞比例與健康人比較差異均無統計學意義.消退期皮損黑素細胞數量高于消退後白斑(P＜0.05),色素顆粒暘性細胞比例略低于消退後白斑,但差異無統計學意義;與健康人比較,消退期皮損黑素細胞數量高,而色素顆粒暘性細胞比例低,均有統計學差異(均P＜ 0.05),消退後白斑的黑素細胞數量與健康人比較差異無統計學意義,而色素顆粒暘性細胞比例降低(P＜0.05).進行期患者皮損中CD4+、CD8+T細胞數與黑素細胞數及色素顆粒暘性細胞比例均無相關性(均P＞ 0.05),而非皮損中CD4+、CD8+T細胞數與黑素細胞數呈正相關(r值分彆為0.46和0.56,均P＜ 0.05),但與色素顆粒暘性細胞比例無明顯相關性(P＞0.05).結論 在銀屑病進行期皮損中,CD4+T細胞和CD8+T細胞明顯增多,基底層黑素細胞數量增加,但色素顆粒明顯減少;皮損消退後,黑素細胞數量及色素顆粒逐漸接近健康人水平.
목적 연구은설병환자피부중CD4+화CD8+T세포여흑소세포적관계화림상의의.방법 취29례진행기은설병환자피손화비피손、5례소퇴기환자피손화비피손급6례건강인피부.면역조화검측CD4+T세포화CD8+T세포적수량화분포,병대비기저층흑소세포화색소과립정황.채용SPSS18.0연건진행통계분석,다조간비교채용단인소방차분석(ANOVA),량조간비교채용최소현저차이법(LSD),상관성분석채용Pearson검험.결과 은설병환자피손중매개고배(×200)시야CD4+T세포평균수(표피5.29±4.66,진피77.50±43.66)명현고우비피손(표피위0,진피9.67±7.73),피손여비피손비교,균P＜ 0.05;이CD8+T세포적수량(표피7.83±6.27,진피46.08±34.26)역명현고우비피손(표피0.71±1.20,진피5.54±4.43),피손여비피손비교,균P＜ 0.05.여건강대조피부상비,은설병환자피손중CD4+T세포화CD8+T세포균명현증다,차이유통계학의의(균P＜ 0.05).은설병피손처기저층흑소세포수량(103.45±16.96)명현고우비피손(43.62±14.20,P＜0.05)급건강인피부(P＜0.05),단색소과립양성세포비례(7.45％±3.86％)명현저우비피손(43.10％±14.91％,P＜ 0.05)급건강인피부(P＜0.05).비피손처CD8+T세포、CD4+T세포、흑소세포수량급색소과립양성세포비례여건강인비교차이균무통계학의의.소퇴기피손흑소세포수량고우소퇴후백반(P＜0.05),색소과립양성세포비례략저우소퇴후백반,단차이무통계학의의;여건강인비교,소퇴기피손흑소세포수량고,이색소과립양성세포비례저,균유통계학차이(균P＜ 0.05),소퇴후백반적흑소세포수량여건강인비교차이무통계학의의,이색소과립양성세포비례강저(P＜0.05).진행기환자피손중CD4+、CD8+T세포수여흑소세포수급색소과립양성세포비례균무상관성(균P＞ 0.05),이비피손중CD4+、CD8+T세포수여흑소세포수정정상관(r치분별위0.46화0.56,균P＜ 0.05),단여색소과립양성세포비례무명현상관성(P＞0.05).결론 재은설병진행기피손중,CD4+T세포화CD8+T세포명현증다,기저층흑소세포수량증가,단색소과립명현감소;피손소퇴후,흑소세포수량급색소과립축점접근건강인수평.
Objective To investigate the relationship of CD4+ and CD8+ T cells with melanocytes in skin of patients with psoriasis,and to study their clinical significance.Methods Tissue specimens were obtained from both lesional and nonlesional skin of 29 patients with progressive psoriasis and 5 patients with regressive psoriasis,as well as from normal skin of 6 healthy individuals.Immunohistochemical staining was performed to determine the quantity and distribution of CD4+ T and CD8+ T cells,as well as the quantity of melanocytes and proportion of cells containing pigment granules in the basal layer of these specimens.Statistical analysis was carried out with the software SPSS 18.0 by one-way analysis of variance (ANOVA),least significant difference (LSD) test and Pearson correlation analysis.Results In patients with psoriasis,the mean number of CD4+ T cells per high-power (× 200) field was significantly larger in lesional skin than in nonlesional skin (epidermis:5.29 ± 4.66 vs.0,P＜ 0.05;dermis:77.50 ± 43.66 vs.9.67 ± 7.73,P＜ 0.05),so was the mean number of CD8+ T cells per high-power (× 200) field (epidermis:7.83 ± 6.27 vs.0.71 ± 1.20,P＜ 0.05;dermis:46.08 ± 34.26 vs.5.54 ± 4.43,P ＜ 0.05).A significant increase was also observed in the number of CD4+ and CD8+ T cells in lesional skin of patients with psoriasis compared with the normal control skin (both P ＜ 0.05).The lesional skin of patients with psoriasis also showed significandy increased number of melanocytes (103.45 ± 16.96),but decreased proportion of pigment granule-containing cells (7.45％ ± 3.86％) in the basal layer compared with nonlesional skin (43.62 ± 14.20,P＜ 0.05;43.10％ ± 14.91％,P＜ 0.05) and normal control skin (43.33 ± 14.02,P＜ 0.05;54.17％ ± 29.40％,P ＜ 0.05).There were no significant differences in either the mean number of CD4+ T cells,CD8+ T cells and melanocytes or the proportion of pigment granule-containing cells between nonlesional psoriatic skin and normal control skin (all P ＞ 0.05).The mean number of melanocytes was significantly higher in regressive psoriatic lesions than in white patches arising in subsided psoriatic lesions (P ＜ 0.05) and normal control skin (P ＜ 0.05),but similar between white patches and normal control skin (P ＞ 0.05),while the proportion of pigment granule-containing cells was insignificantly lower in regressive psoriatic lesions than in white patches (P ＞ 0.05),and significantly lower in regressive psoriatic lesions and white patches than in normal control skin (both P ＜ 0.05).Neither the number of CD4+ T cells nor that of CD8 + T cells was correlated with the number of melanocytes or the proportion of pigment granule-containing cells in progressive psoriatic lesions (both P ＞ 0.05),while the number of both CD4 + T cells and CD8 + T cells was positively correlated with that of melanocytes (r =0.46 and 0.56,respectively,both P ＜ 0.05),but uncorrelated with the proportion of pigment granule-containing cells in nonlesional psoriatic skin (both P ＞ 0.05).Conclusions In progressive psoriatic lesions,there is a significant increase in the number of CD4+ and CD8 + T cells as well as melanocytes in the basal layer,but a significant decrease in the proportion of pigment granule-containing cells.After subsidence of psoriatic lesions,both the number of melanocytes and proportion of pigment granule-containing cells gradually reach the levels in normal skin of healthy individuals.
