系统性硬化症中的皮肤淋巴管微脉管病

Lymphatic microangiopathy of the skin in systemic sclerosis.

作者信息

Leu A J, Gretener S B, Enderlin S, Brühlmann P, Michel B A, Kowal-Bielecka O, Hoffmann U, Franzeck U K

机构信息

Department of Internal Medicine, University Hospital, Zurich, Switzerland.

出版信息

Rheumatology (Oxford). 1999 Mar;38(3):221-7. doi: 10.1093/rheumatology/38.3.221.

DOI:10.1093/rheumatology/38.3.221

PMID:10325660

Abstract

METHODS

The cutaneous capillary lymphatic system in patients with systemic sclerosis was investigated using fluorescence microlymphography. The distal upper limbs of 16 healthy controls (mean age 62.3+/-13.1 yr) and 16 patients with systemic sclerosis (mean age 58.9+/-13.6 yr) were examined and the following parameters were evaluated: (a) single lymphatic capillaries; (b) lymphatic capillary network and cutaneous backflow; (c) extension of the stained lymphatics; (d) diameter of single lymphatic capillaries.

RESULTS

At the finger level, lymphatic capillaries were lacking in five patients, while they were present in all controls (P < 0.05). Extension of the stained lymphatics was increased in 11 patients (8.1+/-6.0 mm) compared to the 16 healthy controls (2.0+/-1.2 mm) (P < 0.0001). Cutaneous backflow was observed in three patients (P < 0.05). At the hand level, lymphatic network extension was significantly different between patients (3.8+/-2.4 mm) and controls (1.2+/-0.8 mm) (P < 0.01); however, no significant differences were found at the forearm level.

CONCLUSION

Lesional skin in patients with systemic sclerosis exhibits evidence of lymphatic microangiopathy.

摘要

方法

采用荧光显微淋巴管造影术对系统性硬化症患者的皮肤毛细血管淋巴系统进行研究。对16名健康对照者（平均年龄62.3±13.1岁）和16名系统性硬化症患者（平均年龄58.9±13.6岁）的上肢远端进行检查，并评估以下参数：（a）单个毛细淋巴管；（b）毛细淋巴管网络和皮肤回流；（c）染色淋巴管的延伸；（d）单个毛细淋巴管的直径。

结果

在手指水平，5名患者缺乏毛细淋巴管，而所有对照者均有（P<0.05）。与16名健康对照者（2.0±1.2mm）相比，11名患者（8.1±6.0mm）的染色淋巴管延伸增加（P<0.0001）。3名患者观察到皮肤回流（P<0.05）。在手部水平，患者（3.8±2.4mm）和对照者（1.2±0.8mm）之间的淋巴管网络延伸有显著差异（P<0.01）；然而，在前臂水平未发现显著差异。