不同颜色分型鲜红斑痣畸形血管的形态学初步研究
发布时间：2018-09-17 12:29
【摘要】： 目的： 通过对不同颜色分型的鲜红斑痣病理标本进行HE染色及免疫组织化学检查,光镜下观察不同分型鲜红斑痣的组织病理变化,对病理图像进行计算机分析,测量不同颜色分型鲜红斑痣畸形血管的平均血管直径、平均血管深度、最大血管深度、数密度等血管参数,探讨不同临床表现鲜红斑痣畸形血管的形态学差异,以期指导临床治疗时采用不同的激光参数,提高治疗效果。 方法： 2008年3月~2009年3月在我科门诊就诊的鲜红斑痣病人中,将两名以上主治医师肉眼观察结果与CM-2600d分光测色仪测到的a*值相结合,据此对所有患者按病灶区颜色不同分为四型：粉红型(I型)、鲜红型(II型)、紫红型(Ⅲ型)及紫红伴结节或增厚型(Ⅳ型)。每型随机选择10例,均未做任何治疗,病灶全部位于面部或颈部。另在40例患者中随机选取10例病灶对侧面颈部正常皮肤组织。2%利多卡因局部麻醉后,用手术刀垂直于病灶采集病灶区组织及正常皮肤组织,常规固定包埋,切片后行HE染色及Ⅷ因子免疫组织化学染色标记血管。HE染色切片在光镜下观察组织病理,重点观察畸形血管。免疫组化染色切片行计算机图像分析处理,测量以下血管参数：平均血管直径、平均血管深度、最大血管深度,并根据体视学原理计算出数密度。各组数据以(x±s)表示,用SPSS16.0软件包进行统计,性别构成检验选用精确概率法,年龄构成检验选用秩和检验,多组均数比较采用完全随机设计资料单因素方差分析,P0.05为差异有统计学意义。 结果： 组织学检查：HE染色可见表皮层正常,真皮浅层毛细血管呈群集扩张状。随着病变颜色加深,血管数目增多,直径增大,部分扩张毛细血管延及真皮深层和皮下组织,含红细胞充盈的毛细血管增多：内皮细胞成熟但不增生。免疫组化检查：Ⅷ因子标记的血管阳性染色示真皮浅、中层可见大量染色呈棕褐色的毛细血管.大部分呈扩张畸形。计算机图像分析：粉红型、鲜红型、紫红型及结节增厚型PWS实验组扩张毛细血管的直径(μm)分别为：55.39±2.74、94.55±2.13、133.85±11.51、171.07±13.75；最大毛细血管深度(mm)分别为：0.51±0.07、0.61±0.16、0.72±0.11、0.87±0.18：平均毛细血管深度(mm)分别为：0.40±0.10、0.43±0.21、0.52±0.08、0.62±0.12；数密度(／mm2)分别为：15.87±0.07、19.14±1.09、22.39±3.10、25.33±2.84。正常对照组的毛细血管直径(μm)为14.23±0.85、最大毛细血管深度(m)为0.51±0.17、平均毛细血管深度(mm)为0.40±0.14、数密度(／mm2)为6.70±0.34。其中平均血管直径和数密度在不同临床表现组有显著性差异：正常组与粉红组的最大血管深度,正常组与粉红组、正常组与鲜红组以及粉红组与鲜红组的平均血管深度无统计学差异,其它各临床表现组之间均有显著性差异。 结论： 随着鲜红斑痣病灶区颜色加深,患者年龄逐渐增大,病灶区血管直径、数密度、最大深度,平均深度亦逐渐增加；粉红型和鲜红型PWS病灶区血管分布位置较浅,主要表现为血管扩张和数目增多；紫红型和结节增厚型PWS病灶区血管分布位置较深,血管扩张明显,单位空间内血管数目增多。随着病灶区颜色加深,临床激光治疗时可选择不同波长的激光器,适当增加脉宽和能量密度等。
[Abstract]:Objective:
By HE staining and immunohistochemical examination on pathological specimens of different color types of nevus flammeus, the histopathological changes of different types of nevus flammeus were observed under light microscope, and the pathological images were analyzed by computer. The mean vessel diameter, average vessel depth and maximum vessel depth of different color types of nevus flammeus were measured. To explore the morphological differences of vascular deformities in different clinical manifestations of port wine stain, and to guide the clinical treatment with different laser parameters, so as to improve the therapeutic effect.
Method:
From March 2008 to March 2009, two or more physicians attending the outpatient department of our department combined naked eye observation with a * value measured by CM-2600d spectrophotometer. All patients were divided into four types according to the color of lesion area: pink (type I), bright red (type II), purple red (type II I) and purple red with nodules or enlargement. Thick type (type IV). Each type was randomly selected in 10 patients without any treatment, and the lesions were all located in the face or neck. Another 40 patients were randomly selected 10 lesions on the side and neck of normal skin tissue. After local anesthesia with 2% lidocaine, the lesions were collected with scalpel perpendicular to the lesion area and normal skin tissue, routinely fixed and embedded, and sectioned. HE staining and factor_immunohistochemical staining were used to label the vessels.HE staining sections were used to observe the histopathology under the light microscope with emphasis on the observation of malformed vessels.Immunohistochemical staining sections were used for computer image analysis.The following vascular parameters were measured: mean vessel diameter, mean vessel depth and maximum vessel depth. The data of each group were expressed as (x 65507
Result:
Histological examination: HE staining showed that the epidermis was normal and the capillaries in the superficial dermis were clustered and dilated. With the deepening of the lesion color, the number and diameter of the capillaries increased. Some dilated capillaries extended to the deep dermis and subcutaneous tissues. The capillaries filled with red blood cells increased. _factor labeled vascular positive staining showed that the dermis was light and a large number of brown capillaries were seen in the middle layer. Most of them were dilated deformities. The maximum capillary depth (mm) were 0.51 (+ 0.07), 0.61 (+ 0.16), 0.72 (+ 0.11), 0.87 (+ 0.18) and the mean capillary depth (mm) were 0.40 (+ 0.10), 0.43 (+ 0.21), 0.52 (+ 0.08), 0.62 (+ 0.12), and the number density (/ mm2) were 15.87 (+ 0.07), 19.14 (+ 1.09), 22.39 (+ 3.10) and 25.33 (+ 2.84) in the control group, respectively. M) was 14.23 [0.85], the maximum capillary depth (m) was 0.51 [0.17], the average capillary depth (m m) was 0.40 [0.14], and the numerical density (/ mm2) was 6.70 [0.34]. There were significant differences in the mean diameter and density of blood vessels between the normal group and the pink group, the normal group and the pink group, the normal group and the bright red group. There was no significant difference in the mean vascular depth between the pink group and the bright red group.
Conclusion:
With the deepening of the color of the lesion area, the age of the patients gradually increased, and the diameter, number density, maximum depth and average depth of the lesion area also gradually increased; the distribution of the blood vessels in the lesion area of pink and bright red PWS was shallow, mainly manifested by the expansion and increase of the number of blood vessels; the distribution of blood vessels in the lesion area of purple and nodular thickening PWS With the darkening of the color of the lesion area, different wavelengths of laser can be selected for clinical treatment, and pulse width and energy density can be increased appropriately.
【学位授予单位】：广州中医药大学
【学位级别】：硕士
【学位授予年份】：2010
【分类号】：R758.51
本文编号：2245926
[Abstract]:Objective:
By HE staining and immunohistochemical examination on pathological specimens of different color types of nevus flammeus, the histopathological changes of different types of nevus flammeus were observed under light microscope, and the pathological images were analyzed by computer. The mean vessel diameter, average vessel depth and maximum vessel depth of different color types of nevus flammeus were measured. To explore the morphological differences of vascular deformities in different clinical manifestations of port wine stain, and to guide the clinical treatment with different laser parameters, so as to improve the therapeutic effect.
Method:
From March 2008 to March 2009, two or more physicians attending the outpatient department of our department combined naked eye observation with a * value measured by CM-2600d spectrophotometer. All patients were divided into four types according to the color of lesion area: pink (type I), bright red (type II), purple red (type II I) and purple red with nodules or enlargement. Thick type (type IV). Each type was randomly selected in 10 patients without any treatment, and the lesions were all located in the face or neck. Another 40 patients were randomly selected 10 lesions on the side and neck of normal skin tissue. After local anesthesia with 2% lidocaine, the lesions were collected with scalpel perpendicular to the lesion area and normal skin tissue, routinely fixed and embedded, and sectioned. HE staining and factor_immunohistochemical staining were used to label the vessels.HE staining sections were used to observe the histopathology under the light microscope with emphasis on the observation of malformed vessels.Immunohistochemical staining sections were used for computer image analysis.The following vascular parameters were measured: mean vessel diameter, mean vessel depth and maximum vessel depth. The data of each group were expressed as (x 65507
Result:
Histological examination: HE staining showed that the epidermis was normal and the capillaries in the superficial dermis were clustered and dilated. With the deepening of the lesion color, the number and diameter of the capillaries increased. Some dilated capillaries extended to the deep dermis and subcutaneous tissues. The capillaries filled with red blood cells increased. _factor labeled vascular positive staining showed that the dermis was light and a large number of brown capillaries were seen in the middle layer. Most of them were dilated deformities. The maximum capillary depth (mm) were 0.51 (+ 0.07), 0.61 (+ 0.16), 0.72 (+ 0.11), 0.87 (+ 0.18) and the mean capillary depth (mm) were 0.40 (+ 0.10), 0.43 (+ 0.21), 0.52 (+ 0.08), 0.62 (+ 0.12), and the number density (/ mm2) were 15.87 (+ 0.07), 19.14 (+ 1.09), 22.39 (+ 3.10) and 25.33 (+ 2.84) in the control group, respectively. M) was 14.23 [0.85], the maximum capillary depth (m) was 0.51 [0.17], the average capillary depth (m m) was 0.40 [0.14], and the numerical density (/ mm2) was 6.70 [0.34]. There were significant differences in the mean diameter and density of blood vessels between the normal group and the pink group, the normal group and the pink group, the normal group and the bright red group. There was no significant difference in the mean vascular depth between the pink group and the bright red group.
Conclusion:
With the deepening of the color of the lesion area, the age of the patients gradually increased, and the diameter, number density, maximum depth and average depth of the lesion area also gradually increased; the distribution of the blood vessels in the lesion area of pink and bright red PWS was shallow, mainly manifested by the expansion and increase of the number of blood vessels; the distribution of blood vessels in the lesion area of purple and nodular thickening PWS With the darkening of the color of the lesion area, different wavelengths of laser can be selected for clinical treatment, and pulse width and energy density can be increased appropriately.
【学位授予单位】：广州中医药大学
【学位级别】：硕士
【学位授予年份】：2010
【分类号】：R758.51
【参考文献】
相关期刊论文 前10条
1 李勤;彭丽霞;曾东;余文林;苑凯华;;585nm与532nm激光治疗鲜红斑痣的疗效比较[J];广东医学;2007年01期
2 李勤;彭丽霞;苑凯华;余文林;程飚;柳大烈;;光动力疗法对鲜红斑痣血管组织学的影响探讨[J];广东医学;2010年07期
3 肖和;杨志强;杨正文;刘勤;徐霖;王肃生;;强脉冲光联合脉冲染料激光治疗鲜红斑痣的临床疗效分析[J];广州医学院学报;2008年01期
4 廖小华;王颖;陈荣;顾瑛;;光谱法用于血氧饱和度无损测量[J];激光与光电子学进展;2008年01期
5 王彦进,宫昔愿,孙学武,郭丹凤,娄焕民;Q开关闪光灯泵浦脉冲染料激光治疗鲜红斑痣148例[J];临床皮肤科杂志;2005年07期
6 李勤;廖元兴;彭丽霞;曾东;苑凯华;;脉冲染料激光治疗鲜红斑痣的临床疗效评价[J];临床皮肤科杂志;2007年04期
7 张安利;祖冬梅;杨力;王璐;;5-氨基酮戊酸光动力学治疗鲜红斑痣28例[J];中国美容医学;2007年04期
8 何葆华;金珏;俞锡娟;黄荣;;葡萄酒色斑的Waner分型与治疗[J];中国美容整形外科杂志;2006年06期
9 苑凯华;余文林;李勤;王伟莲;蔡金辉;;光动力疗法联合脉冲染料激光治疗鲜红斑痣临床分析[J];应用激光;2006年06期
10 顾瑛,刘凡光,王开,朱建国,梁洁,潘玉明,李峻亨;光动力疗法治疗鲜红斑痣1216例临床分析[J];中国激光医学杂志;2001年02期
，本文编号：2245926
本文链接：https://www.wllwen.com/yixuelunwen/pifb/2245926.html
最近更新
教材专著
