超声观察高原日光照射对正常人皮肤厚度及硬度的影响

目的 探讨高频超声及剪切波弹性成像（SWE）评估高原日光照射对皮肤厚度及硬度的影响。方法 招募30名高原地区（高原组）、48名非高原地区（非高原组）志愿者，以高频超声及SWE测量右侧中指、右侧前臂、前胸壁及腹壁4个部位皮肤厚度及皮肤硬度。比较2组间4个部位皮肤厚度及硬度差异；选取皮肤厚度及弹性值差异有统计学意义的参数，行诊断性试验，并绘制ROC曲线。结果 高原组右侧中指皮肤厚度、最大弹性值（E_max）、平均弹性值（E_mean）、最小弹性值（E_min）及弹性值标准差（Esd），右侧前臂及前胸壁皮肤E_max、E_mean、E_min，腹壁皮肤E_max、E_mean、E_min、Esd均大于非高原组（P均<0.05）；前胸壁及腹壁皮肤厚度小于非高原组（P均<0.05）。根据腹壁皮肤E_max、E_mean及E_min诊断高原地区皮肤的ROC曲线AUC均>0.95。以腹壁皮肤E_max=13.30 kPa、E_mean=12.45 kPa、E_min=11.50 kPa为界值，诊断高原地区皮肤的敏感度均为100%，特异度分别为85.40%、87.50%及85.40%。结论 高原日光照射会导致皮肤厚度改变和皮肤硬度增加；腹壁皮肤弹性值E_max、E_mean及E_min的诊断效能最高。

Ultrasonic observation on impact of plateau sunlight radiation on skin thickness and hardness of normal subjects

Objective To observe the impact of plateau sunlight radiation on skin thickness and hardness with high frequency ultrasound and shear wave elastography (SWE). Methods Totally 30 volunteers from plateau areas (plateau area group) and 48 volunteers from non-plateau areas (non-plateau area group) were enrolled. Skin thickness and skin hardness of right middle finger, right forearm, anterior chest wall and abdominal wall were measured with high frequency ultrasound and SWE and then compared between two groups. Diagnostic test of the above parameters which showed significant differences were performed, and ROC curve were drawn. Results Skin thickness, maximum elastic value (E_max), average elastic value (E_mean), minimum elastic value (E_min) and standard deviation (Esd) of right middle fingers, skin E_max, E_mean, E_min of right forearms and anterior chest walls, skin E_max, E_mean, E_min, Esd of abdominal walls of plateau area group were all higher than those of non-plateau area group (all P<0.05), while skin thickness of anterior chest wall and abdominal wall of plateau area group were lower than those of non-plateau area group (both P<0.05). Skin E_max, E_mean, E_min of abdominal wall had the largest AUC in diagnosis of plateau skin, which were all >0.95. Taken skin E_max=13.30 kPa, E_mean=12.45 kPa, E_min=11.50 kPa of abdominal wall as cut off values, the sensitivities in diagnosis of plateau skin were all 100%, and specificities were 85.40%, 87.50% and 85.40%, respectively. Conclusion Plateau sunlight radiation lead to changes of skin thickness and make the skin harden. Skin E_max, E_mean, E_min of abdominal wall have the highest diagnostic efficiencies.