38例大疱性类天疱疮的临床表现、组织病理及免疫荧光检查结果分析  

Clinical manifestation,histopathology and immunofluorescence examination results analysis of 38 cases of bullous pemphigoid

作　　者：石国英 闫小宁 杨昌伟 SHI Guoying;YAN Xiaoning;YANG Changwei(Pathology Department,Shaanxi Provincial Hospital of Chinese Medicine,Xi'an 710003;Dermatology Department,Shaanxi Provincial Hospital of Chinese Medicine,Xi'an 710003;Emergency Department,Honghui Hospital,Xi'an 710054,China)

机构地区：[1]陕西省中医医院病理科,陕西西安710003 [2]陕西省中医医院皮肤科,陕西西安710003 [3]西安市红会医院急诊科,陕西西安710054

出　　处：《临床医学研究与实践》2022年第7期39-42,共4页Clinical Research and Practice

基　　金：陕西省创新能力支撑计划项目(No.2017KCT-27)。

摘　　要：目的研究大疱性类天疱疮(BP)的临床表现、组织病理及免疫荧光特点,旨在为BP患者的临床诊断提供参考依据。方法回顾性分析38例BP患者的临床资料、组织病理及直接免疫荧光(DIF)检查结果。结果38例BP患者中,男性23例,女性15例;患者发病年龄为36~88岁,平均发病年龄(68.32±13.85)岁;35例患者Nikolsky征检查为阴性。组织病理表现为表皮下裂隙及水疱形成,疱壁表皮完整,未见棘层松解。DIF检查显示表皮、真皮交界处基底膜带出现绿色荧光信号,C3、IgG于基底膜带呈线状沉积。结论中老年患者皮肤出现紧张性水疱,应考虑BP可能,临床表现、组织病理、免疫荧光检查相结合能有效提高BP诊断的准确率,有效地防止漏诊、误诊,值得临床推广应用。Objective To study the clinical manifestation,histopathology and immunofluorescence characteristics of bullous pemphigoid(BP),in order to provide reference basis for the clinical diagnosis of BP patients.Methods The clinical data,histopathology and direct immunofluorescence(DIF)examination results of 38 patients with BP were analyzed retrospectively.Results Among the 38 patients with BP,23 cases were male and 15 cases were female;the age of onset was 36-88 years,the average age of onset was(68.32±13.85)years;Nikolsky sign was negative in 35 patients.Histopathology showed the formation of subepidermal fissures and blisters,with integrated epidermis of blister wall,with no relaxation on stratum spinosum.DIF examination showed that green fluorescence signal appeared in the basement membrane zone at the junction of epidermis and dermis,and C3 and IgG were linearly deposited in the basement membrane zone.Conclusion The possibility of BP should be considered when tension blisters appear on the skin of middle-aged and elderly patients.The combination of clinical manifestations,histopathology and immunofluorescence examination can effectively improve the accuracy of BP diagnosis and effectively prevent missed diagnosis and misdiagnosis,which is worthy of clinical promotion and application.

关 键 词：大疱性类天疱疮 组织病理 免疫荧光检测 

分 类 号：R758.6[医药卫生—皮肤病学与性病学]