反射式共聚焦显微镜在局限性硬皮病疗效评估中的应用  

Reflectance confocal microscopy for assessing efficacy in localized scleroderma

作　　者：张宏志 于咏梅 李洪达[1,2] 王秀环 刘鑫洲 陈声利 刘红[1,2] ZHANG Hongzhi;YU Yongmei;LI Hongda;WANG Xiuhuan;LIU Xinzhou;CHEN Shengli;LIU Hong(Hospital for Skin Diseases,Shandong First Medical University,Jinan 250022,China;Shandong Provincial Institute of Dermatology and Venereology,Shandong Academy of Medical Sciences,Jinan 250022,China)

机构地区：[1]山东第一医科大学附属皮肤病医院,山东济南250022 [2]山东省皮肤病性病防治研究所,山东济南250022

出　　处：《中国麻风皮肤病杂志》2025年第4期267-271,共5页China Journal of Leprosy and Skin Diseases

基　　金：山东省皮肤性病学临床医学研究中心。

摘　　要：目的:评价反射式共聚焦显微镜(RCM)在局限性硬皮病治疗随访中的应用价值。方法:回顾性分析我院14例经组织病理证实为局限性硬皮病患者治疗随访期间(治疗前、治疗后4~6个月和12~15个月)RCM图像特征,并与患者的临床结局进行相关性分析。结果:治疗后12~15个月,14例患者中13例病情好转,mLoSSI和LoSDI评分均下降,1例病情恶化,mLoSSI评分无变化,LoSDI评分升高。13例好转患者RCM变化:6例患者胶原纤维恢复为细网状结构,7例真皮胶原密度降低;13例患者真皮反射指数均下降;7例真表皮交界处清晰度显著改善,4例可见真皮微循环建立。病情恶化患者胶原纤维形态、真皮反射指数及真表皮交界处清晰度均无明显改善。结论:RCM是监测局限性硬皮病胶原形态变化和血管改变的有效手段。Objective:To evaluate the application value of reflectance confocal microscopy(RCM)in the follow-up of localized scleroderma.Methods:Retrospectively analyze the RCM image characteristics of 14 patients with localized scleroderma confirmed by histopathology in our hospital during the follow-up period(before treatment,4-6 months and 12-15 months after treatment),and analyze the correlation with the efficacy of the patients.Results:After 12-15 months treatment,13 out of 14 patients showed improvement,with decreased mLoSSI and LoSDI scores.One patient's condition deteriorated,with no change in the mLoSSI score and an increased LoSDI score.RCM changes in the 13 improved patients:In 6 patients,the collagen fibers recovered to a fine reticular structure,and in 7 patients,the dermal collagen density decreased;the dermal reflectance index of all 13 patients decreased;the clarity of the dermo-epidermal junction was significantly improved in 7 patients,and dermal microcirculation was visible in 4 patients.In the patient with deteriorated condition,there were no obvious improvements in the collagen fiber morphology,dermal reflectance index,and clarity of the dermo-epidermal junction.Conclusion:RCM is an effective tool for monitoring the collagen morphological changes and vascular alterations in localized scleroderma.

关 键 词：局限性硬皮病 反射式共聚焦激光扫描显微镜 皮肤纤维化 

分 类 号：R593.25[医药卫生—内科学]