Klemp P, Staberg B
J Invest Dermatol. 1985 Sep;85(3):259-63. doi: 10.1111/1523-1747.ep12276742.
In 8 patients with psoriasis vulgaris, the cutaneous blood flow (CBF) was measured simultaneously in both involved and uninvolved psoriatic skin before (i.e., on the first day of hospitalization) and on the 3rd, 7th, 14th, and 28th days of treatment with tar. The 133Xe washout method was used after epicutaneous labeling and compared to the laser Doppler velocimetry (LDV) technique. Control experiments were performed in 10 normal individuals. Before treatment the mean CBF in involved psoriatic skin was 62.6 +/- 18.7 SD ml X (100 g X min)-1, which is significantly higher than CBF of uninvolved skin in psoriatic patients, 9.5 +/- 4.0 SD ml X (100 g X min)-1, (p less than 0.01) and is 13.6 times higher than CBF in the normal individuals (p less than 0.01). Fifty hours following onset of treatment (i.e., after only 2 applications of tar), mean CBF of the involved psoriatic skin had decreased significantly to 35.0 +/- 13.9 SD ml X (100 g X min)-1, (p less than 0.01), which was not statistically different from the CBF on the 7th day. During the following weeks, the CBF in involved psoriatic skin decreased at a more moderate rate than that observed during the first week and was 15.0 +/- 6.1 SD ml X (100 g X min)-1 on the 28th day. This value is not significantly different from the CBF of uninvolved skin in these patients. At the end of treatment, the CBF of the uninvolved skin had decreased significantly (p less than 0.05) in all the patients to values similar to those observed in the skin of normal individuals. A parallel decline was observed in a clinical psoriatic score index; however, it is not known whether the observed decrease in CBF was preceded or succeeded by the clinical improvement. A comparison of the 133Xe measurements and LDV measurements in the normal individuals by linear regression analysis yielded a correlation coefficient of -0.24 (N = 20, p greater than 0.05). In the skin of psoriatic patients the correlation coefficient was 0.01, (N = 47, p greater than 0.05) for unaffected skin, and 0.61 (N = 47, p less than 0.001) in the involved psoriatic skin sites. The LDV measurements did not reflect changes in the uninvolved skin in psoriatic patients during treatment and resulted in a remarkably high C.V. in the bilateral measurements of skin in normal individuals (43.8%) compared to the C.V. of 133Xe flow measurements (14.8%). It is concluded that while the LDV method gives a rough estimate of blood flow in cutaneous tissue with a high capillary perfusion rate, inaccurate measurements are made in skin areas with normal to twice the normal CBF range.
对8例寻常型银屑病患者，在住院第一天（即治疗前）以及用焦油治疗的第3、7、14和28天，同时测量银屑病受累皮肤和未受累皮肤的皮肤血流量（CBF）。采用经皮标记后用133Xe洗脱法，并与激光多普勒测速（LDV）技术进行比较。对10名正常个体进行了对照实验。治疗前，银屑病受累皮肤的平均CBF为62.6±18.7 SD ml×(100 g×min)-1，显著高于银屑病患者未受累皮肤的CBF，即9.5±4.0 SD ml×(100 g×min)-1（p<0.01），且比正常个体的CBF高13.6倍（p<0.01）。治疗开始50小时后（即仅涂抹2次焦油后），受累银屑病皮肤的平均CBF显著降至35.0±13.9 SD ml×(100 g×min)-1（p<0.01），与第7天的CBF无统计学差异。在接下来的几周内，受累银屑病皮肤的CBF下降速度比第一周时更为平缓，第28天时为15.0±6.1 SD ml×(100 g×min)-1。该值与这些患者未受累皮肤的CBF无显著差异。治疗结束时，所有患者未受累皮肤的CBF均显著下降（p<0.05），降至与正常个体皮肤中观察到的值相似。临床银屑病评分指数也出现了平行下降；然而，尚不清楚观察到的CBF下降是先于还是后于临床改善出现。通过线性回归分析比较正常个体中133Xe测量值和LDV测量值，相关系数为-0.24（N = 20，p>0.05）。在银屑病患者的皮肤中，未受累皮肤的相关系数为0.01（N = 47，p>0.05），而受累银屑病皮肤部位的相关系数为0.61（N = 47，p<0.001）。LDV测量未反映银屑病患者治疗期间未受累皮肤的变化，并且与133Xe血流测量的变异系数（14.8%）相比，正常个体皮肤双侧测量的变异系数非常高（43.8%）。结论是，虽然LDV方法能大致估计毛细血管灌注率高的皮肤组织中的血流，但在CBF为正常至正常两倍范围的皮肤区域测量不准确。
