中华皮肤科杂志 ›› 1993, Vol. 26 ›› Issue (2): 83-86.

• 论著 • 上一篇    下一篇

NaCl分离皮肤为底物的IIF法鉴别诊断表皮下大疱病

靳培英, 林麟, 是元甫, 马林, 桑红桂, 沈丹蓓   

  1. 中国医学科学院皮肤病研究所, 南京, 210042
  • 收稿日期:1992-02-18 修回日期:1992-07-06 出版日期:1993-04-15 发布日期:1993-04-15

Evaluation of the practicality of IIF with 1.0 M NaCI-splitted human skin as a substrate in the differentiation of subepidermal bnilous diseases

JIN Pei-Ying, LIN Lin   

  1. Institute of Dermatology, Chinese Academy of Medical Sciences, Nanjing 210042
  • Received:1992-02-18 Revised:1992-07-06 Online:1993-04-15 Published:1993-04-15

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摘要： 对1989~1991年间,在本所就诊的100例表皮下大疱病,通过临床、组织病理、直接免疫荧光(DIF)、间接免疫荧光(IIF)法以及1M NaCl分离皮肤为底物的IIF法进行了诊断和评价.结果发现DIF检查的100例中有76例皮肤BMZ有免疫反应物沉积,另24例为阴性,但有典型的自身免疫性大疱病的临床表现;根据临床、DIF和分离皮IIF法修正诊断出大疱性类天疱疮(BP)54例、获得性大疱性表皮松解症(EBA)8例、线状IgA大疱性皮病(LABD)7例(成人4、儿童3),瘢痕性类天疱疮(CP)7例、水疱性红斑狼疮(BSLE)3例、迟发性皮肤卟啉症(PCT)2例、BP和寻常型天疱疮(PV)并发1例,BP和疱疹样皮炎(DH)并发1例,有17例未定.研究结果发现分离皮IIF法对提高表皮下大疱病的诊断水平有较重要的应用价值.但由于CP的抗BMZ抗体可分别出现在表皮侧或真皮侧,所以分离皮IIF法不能单独鉴别CP和BP、CP和EBA.应该结合临床、免疫印迹和免疫电镜等方法进一步诊断,从而也表明分离皮IIF法有一定的局限性.

关键词: 皮肤病, 大疱性

Abstract: The pager describes the patients with subepidermal bullous diseases (SBD) attending our clinic from 1989 to 1991. According to the clinical and histopathological examination, DIP and IIF test, and IIF test with 1.0 M NaCl-spiilted human satin as a substrate,100 cases of SBD were evaluated and diagnosed. Among them, 54 cases of BP, 8 cases of EBA, 7 cases of LARD, 7 cases of CP, 3 cases of BSLE, 2 cases of PCT, 2 cases of mixed bullous diseases (coexistence of pemphigus vulgaris and BP. dermatitis herpetiformis and BP) were differentiated. Seventeen cases remained to be defined. The result of this study indicates that NaCl-separated human skin as a substrate for IIF test plays an important role in the diagnosis on classification of SBD. Because the antibody in CP setltm may deposit on the epidermis side or dermis side in NaCl-spiitted skin IIF test. this method alone cannot be used for distinguishing CP and BP or CP and EBA. It should be integrated with clinical findings and other laboratory examinations, e.g. immunoblotting and immunoelectron microscopy for definite diagnosis of some cases.

Key words: Skin diseases, bullous