青斑样血管病的病理特征探讨  

Discussions of Pathological Features of Livedoid Vasculopathy

作　　者：马梦兰 刘亚美 曹育春[1] Ma Menglan;Liu Yamei;Cao Yuchun(Department of Dermatology,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430030,China)

机构地区：[1]华中科技大学同济医学院附属同济医院皮肤科,武汉430030

出　　处：《华中科技大学学报（医学版）》2022年第4期550-552,共3页Acta Medicinae Universitatis Scientiae et Technologiae Huazhong

基　　金：国家自然科学基金资助项目(No.81974308)。

摘　　要：目的探讨青斑样血管病(livedoid vasculopathy,LV)的特征性病理表现。方法收集华中科技大学同济医学院附属同济医院确诊的24例早期青斑样血管病及32例变应性血管炎患者的临床资料并进行前瞻性病理随访观察,采用平行对照和自身前后对照比较分析青斑样血管病的病理特征。结果早期青斑样血管病的组织病理表现为真皮浅层血管内透明血栓形成、管周少量淋巴细胞浸润及血管壁透明变性比率高于变应性血管炎组(均P<0.05)。青斑样血管病在随访期间多次复发后表现出虫蚀状溃疡及白色萎缩等典型临床表现(均P<0.05)。青斑样血管病自身前后对照显示:该病早期和进展期出现真皮小血管透明血栓形成比例分别为69.2%和76.9%,少量淋巴细胞浸润比例分别为92.3%和84.6%,差异无统计学意义(均P>0.05),进展期出现血管壁透明变性比率高于早期(P<0.05)。结论真皮浅层血管内透明血栓形成及管周少量淋巴细胞浸润可视为青斑样血管病的特征性病理改变。Objective To explore the typical pathological manifestations of livedoid vasculopathy.Methods The clinical data of 24 patients with early stage livedoid vasculopathy and 32 patients with allergic vasculitis diagnosed in Tongji Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology were collected,and prospective follow-up study on pathology was performed.Parallel control and self-control were adapted to compare and analyze the characteristic pathological manifestations of livedoid vasculopathy.Results The histopathological manifestation of early-stage livedoid vasculopathy group was that the rates of hyaline thrombosis in the superficial dermis,mild lymphocyte infiltration and hyaline degeneration of the blood vessel wall were higher than those in the allergic vasculitis group(all P<0.05).Typical clinical manifestations of livedoid vasculopathy included worm-eaten ulcers and white atrophy after repeated recurrences during the follow-up period(both P<0.05).The rates of hyaline thrombosis in small blood vessels of the dermis were 69.2%in the early-stage and 76.9%in progressive stage,and the rates of mild lymphocyte infiltration were 92.3%and 84.6%respectively,the differences were not statistically significant(both P>0.05).The rate of hyaline degeneration of vascular wall in the progressive stage was higher than that in the early-stage(P<0.05).Conclusion The hyaline thrombosis in the superficial dermis and mild lymphocytes infiltration around the blood vessels can be regarded as the characteristic pathological changes of livedoid vasculopathy.

关 键 词：青斑样血管病 变应性血管炎 病理特征 

分 类 号：R751[医药卫生—皮肤病学与性病学]