摘要
目的：比较直接进行斑贴试验（patchtest，PT）与先反复多次进行胶带粘贴（tapestripping，TAP）再进行斑贴试验（tapestripping＋pacthtest，TAPPT）后皮肤反应的异同，探讨已受到亚临床刺激的皮肤对再次发生的刺激性皮炎严重程度的影响。方法：30名健康女性双前臂屈侧按随机原则分别进行TAP、PT、TAPPT及空白对照4种处理。TAP共5d，PT于第6天进行。试验期间每天进行临床评估，第0、第6天胛前及第7、第8天进行经表皮水分丢失率、表皮含水量、Chromameter a＊值及皮肤表面pH值的检测。结果：①PT、TAPPT刺激率分别为60％、100％，TAPPT刺激率高于PT（P〈0．05）。（2）TAPPT评分高于PT（P〈0．05）。③与基础值相比，第8天，PT与TAPPT的经表皮水分丢失率值均升高，TAP门部位△B-8表皮水分丢失率值大于PT部位△B-8表皮水分丢失率值（P〈0．05）。与第7天相比，第8天PT、TAPPT的经表皮水分丢失率值均下降，TAPPT△7-8经表皮水分丢失率值小于PT△7-8经表皮水分丢失率值（P〈0．05）。④与基础值相比，第8天PT的表皮含水量下降，TAPPT的表皮含水量上升，PT部位△B-8。表皮含水量与TAPPT部位△B-8表皮含水量差异有显著性（P〈0．05）。⑤与基础值相比，PT、TAPPT部位的a＊值均升高，TAPPT△B-8 a＊值高于PT△B-8 a＊值（P〈0．05）。⑥PT部位临床评分与经表皮水分丢失率、a＊值正相关，TAPPT部位临床评分与经表皮水分丢失率、表皮含水量、a＊值、pH值之间正相关。结论：①当皮肤屏障经胶带粘贴后产生亚临床刺激的破坏，如再次发生刺激性皮炎，会增加其发生率，增强其严重程度。②经表皮水分丢失率、表皮含水量、Chromameter a＊值能反映皮肤受到TAP及PT刺激后的变化，可作为评判刺激性接触性皮炎的客观参数。
Objective： Compared the severity of the irritation induced by patch test （PT） and that induced by tape stripping （TAP） and patch test （TAPPT）, to study whether the severity of irritated dermatitis is affected by damaged epidermal barrier. Methods：Thirty healthy female subjects took part in the study. Each subject accepted 4 disposals in her ventral forearm according to randomization, i.e. tape stripping for 5 days （TAP）, patching test over 6 days （PT）, first tape stripping for 5 days then patching test in 6th day （TAPPT） and the blank control. Clinical evaluation was assessed everyday before giving stimuli to subjects. Transepidermal water loss （TEWL）, Caeitance （CAP）, Chroma meter a＊ and skin pH were measured on 0, 6th, 7th and 8th day. Results：（1） The ratio of irritant of PT and TAPPT was 60% and 100% respectively, TAPPT was obviously higher than PT （P〈0.05）. （2）Clinieal score of TAPPT was significant higher than that of PT（P〈0.05）. （3）Compared with baseline, TEWL of PT and TAPPT all increased after the patch was removed. △B-8 TEWL of TAPPT was significant greater than that of FT. Compared with TEWL on 7th day, TEWL of PT and TAPPT all decreased on 8th day. △7-8 TEWL of TAPPT was significantly less than that of PT（P〈0.05）. （4）Compared with baseline, CAP of PT decreased whereas that of TAPPT increased. △B-8 CAP of PT and that of TAPPT had significant difference（P〈0.05）. （5）Compared with baseline, a＊ value of PT and TAPPT all increased. △B-8 a＊ of TAPPT was significantly higher than that of PT （P〈0.05）, （6） Clinical score of PT had positive correlation with TEWL and a＊ value. Clinical score of TAPPT had positive correlation with TEWL, CAP, a＊ value and pH value. Conclusions： （1）When skin barrier has been destroyed by subclinical irritant, ratio and severity of succession irritant contact dermatitis will be strengthen.（2）TEWL,CAP and a＊ value can reflect the change of skin that is induced by tape stripping and patch test. These biophysical values can be used as objective parameters to assess the severity of irritant contact dermatitis.
出处
《临床皮肤科杂志》
CAS
CSCD
北大核心
2010年第9期553-556,共4页
Journal of Clinical Dermatology
