欢迎来到《四川大学学报(医学版)》
孙偲, 杨裕佳, 王丽芸等. 高频超声对系统性硬皮病皮肤厚度定量评估的初步研究[J]. 四川大学学报(医学版), 2018, 49(3): 453-458.
引用本文: 孙偲, 杨裕佳, 王丽芸等. 高频超声对系统性硬皮病皮肤厚度定量评估的初步研究[J]. 四川大学学报(医学版), 2018, 49(3): 453-458.
SUN Si, YANG Yu-jia, WANG Li-yun. et al. Quantitative Assessment of Skin Thickness using High Frequency Ultrasound in Systemic Sclerosis[J]. Journal of Sichuan University (Medical Sciences), 2018, 49(3): 453-458.
Citation: SUN Si, YANG Yu-jia, WANG Li-yun. et al. Quantitative Assessment of Skin Thickness using High Frequency Ultrasound in Systemic Sclerosis[J]. Journal of Sichuan University (Medical Sciences), 2018, 49(3): 453-458.

高频超声对系统性硬皮病皮肤厚度定量评估的初步研究

Quantitative Assessment of Skin Thickness using High Frequency Ultrasound in Systemic Sclerosis

  • 摘要: 目的 探讨高频超声定量评估系统性硬皮病(systemic sclerosis, SSc)患者皮肤厚度的价值,为SSc患者皮肤厚度的临床评估寻找一种客观定量、简单可行的评价方法。方法 确诊为SSc患者82例(SSc组),67例健康志愿者为对照组。对照组与SSc患者均行高频超声测量皮肤厚度,测量部位包括双侧手指、双侧前臂,胸壁,腹壁。SSc患者进行改良Rodnan皮肤评分(mRSS)。比较SSc组与健康对照组年龄、性别、身高、体质量、体质量指数(BMI)、皮肤厚度有无差异,采用受试者工作特征(ROC)曲线评价高频超声在SSc中的诊断效能,分析皮肤厚度与mRSS的相关性。结果 SSc组与健康对照组年龄、性别比、身高、体质量及BMI差异均无统计学意义(P>0.05)。SSc组皮肤厚度在手指及前臂均高于对照组,差异有统计学意义(P <0.05)。ROC曲线分析高频超声评估SSc皮肤厚度,在右、左手指,右、左前臂,胸、腹壁的ROC曲线下面积(AUC)分别为0.938、0.905、0.608、0.586、0.398、0.321;其中,右、左手指的AUC>0.9,可用于诊断,其皮肤厚度诊断SSc阈值分别为1.35 mm、1.26 mm时,其敏感性分别为84.1%、86.6%,特异性分别为95.5%、89.6%。各检测部位mRSS评分越高,皮肤厚度值越大;皮肤mRSS评分之和(mRTSS)与皮肤厚度总和的相关性为r=0.599 (P<0.001),各部位mRSS评分与其皮肤厚度的相关性为0.400~0.623(P<0.001),相关性在腹壁最低,右侧手指最高。结论 高频超声能敏感反映SSc患者皮肤受累程度,其诊断SSc在手指具有较高的特异性和敏感性,高频超声有望成为评价SSc病情及治疗随访的有效定量指标。

     

    Abstract: Objective To investigate the performance of high frequency ultrasound in the assessment of skin thickness in patients with systemic sclerosis (SSc). Methods The study included 82 SSc (SSc group)and 67 healthy volunteers (control group) from 2014 to 2016. The skin thickness at bilateral middle fingers and forearms, anterior chest and abdominal wall was measured using high frequency ultrasound. All the patients with SSc underwent the modified rodnan skin score (mRSS) over 17 anatomical sites by an experienced dermatologist. The differences in age, sex, height, body mass, body mass index (BMI) and skin thickness between SSc patients and healthy controls were compared. Receiver operating characteristic (ROC) curve analysis was performed to determine the performance of high frequency ultrasound in the differentiation of SSc from healthy skin, and the correlation of mRSS with skin thickness were analyzed. Results SSc patients and healthy controls shared similar demographic features (age, sex ratio, height, body mass, BMI) (P>0.05). Skin thickness values in SSc patients were increased significantly at fingers and forearms compared with healthy controls (P<0.05). The area under the curve (AUC) was 0.938,0.905,0.608,0.586,0.398,0.321 at right and left finger, right and left forearm, chest and abdominal wall. Among them, AUC>0.9 of right and left fingers can be used for diagnosis, The skin thickness cut-off value for determining the diagnosis of SSc were as follows: 1.35 mm at the right finger with 84.1% sensitivity and 95.5% specificity, 1.26 mm at the right forearm with 86.6% sensitivity and 89.6% specificity, respectively. Skin thickness increased significantly with mRSS. The correlation of total mRSS scores with total skin thickness was 0.599 (P<0.001), and the correlation of local mRSS score with local skin thickness were 0.400-0.623 (P<0.001), with the highest correlation coefficient at right finger and the lowest at abdomen. Conculusions High frequency ultrasound may reflect extent of skin involvement of SSc, and skin thickness assessed with high frequency ultrasound appeared to be highly specific and sensitive at fingers.

     

/

返回文章
返回