银屑病患者皮肤中T细胞与黑素细胞的检测及临床意义  

Detection of T cells and melanocytes in skin of patients with psoriasis and their clinical significance

作　　者：栾超[1] 陈浩[1] 杨永红[1] 姜祎群[1] 刘毅[1] 陈敏[1] 王宝玺[1] 

机构地区：[1]中国医学科学院北京协和医学院皮肤病医院,江苏省皮肤病与性病分子生物学重点实验室,南京210042

出　　处：《中华皮肤科杂志》2015年第4期240-244,共5页Chinese Journal of Dermatology

摘　　要：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（＆#215;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�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 （＆#215; 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 （＆#215; 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 psor

关 键 词：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 

分 类 号：R758.63[医药卫生—皮肤病学与性病学]