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中华损伤与修复杂志(电子版) ›› 2019, Vol. 14 ›› Issue (02) : 113 -117. doi: 10.3877/cma.j.issn.1673-9450.2019.02.007

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论著

Bland-Altman图评价高频超声和病理测量大鼠皮肤厚度的一致性研究
周浩1, 张永存1, 王光毅1, 唐洪泰1,(), 夏照帆1   
  1. 1. 200433 上海,海军军医大学第一附属医院烧创伤中心
  • 收稿日期:2019-02-02 出版日期:2019-04-01
  • 通信作者: 唐洪泰
  • 基金资助:
    国家自然科学基金国际(地区)合作与交流项目(81120108015); 国家973计划项目(2012CB518100); 国家自然科学基金面上项目(81372057); 上海市卫生和计划生育委员会科研课题(20174Y0059)

Application of Bland-Altman plot in evaluating the agreement between high-frequency and histology for measuring skin thickness in rats

Hao Zhou1, Yongcun Zhang1, Guangyi Wang1, Hongtai Tang1,(), Zhaofan Xia1   

  1. 1. Burn Trauma Center, First Affiliated Hospital of Naval Military Medical University, Shanghai 200433, China
  • Received:2019-02-02 Published:2019-04-01
  • Corresponding author: Hongtai Tang
  • About author:
    Corresponding author: Tang Hongtai, Email:
引用本文:

周浩, 张永存, 王光毅, 唐洪泰, 夏照帆. Bland-Altman图评价高频超声和病理测量大鼠皮肤厚度的一致性研究[J]. 中华损伤与修复杂志(电子版), 2019, 14(02): 113-117.

Hao Zhou, Yongcun Zhang, Guangyi Wang, Hongtai Tang, Zhaofan Xia. Application of Bland-Altman plot in evaluating the agreement between high-frequency and histology for measuring skin thickness in rats[J]. Chinese Journal of Injury Repair and Wound Healing(Electronic Edition), 2019, 14(02): 113-117.

目的

探讨高频超声测量大鼠供皮区皮肤各层厚度的准确性。

方法

以购自海军军医大学动物实验中心的10只SD大鼠为对象,每只大鼠构建4个供皮区模型,共40个供皮区模型,分别应用高频超声和组织病理学方法,测量大鼠供皮区表皮厚度、真皮厚度、全层皮肤厚度以及断层皮片厚度,Bland-Altman散点图计算测量数据的95%一致性界限(95%LOA)。

结果

Bland-Altman散点图显示两种方法测量表皮厚度、真皮厚度、全层皮肤厚度以及断层皮片厚度差值的95%LOA分别为(-15.80~14.30 μm,P=0.54)、(-9.99~8.59 μm, P=0.36)、(-32.33~32.03 μm, P=0.95)、(-33.62~32.87 μm, P= 0.89)。两种方法测量表皮厚度差值和断层皮片厚度差值的点都分别在其95%LOA内,真皮厚度、全层皮肤厚度差值各仅有1个点落其95%LOA外。真皮厚度、全层皮肤厚度以及断层皮片厚度测量差值的95%LOA全部在临床可接受的范围内,表皮厚度测量差值的95%LOA有95%的点在临床可接受的范围内。

结论

高频超声测量大鼠供皮区皮肤各层厚度的数据与组织病理学测量数据具有较好的一致性。高频超声作为一种无创、快速、准确、客观的方法,可望在供皮区取皮深度评估中得到广泛应用。

Objective

To investigate the accuracy of high-frequency ultrasound for measuring the thickness of each layer of rat skin from a donor site.

Methods

Establishing 40 models of the donor site which came from ten SD rats. The thickness of each layer of skin from rat donor sites and the thickness of split skin were measured using high-frequency ultrasound and histology, respectively, and then the 95% limits of agreement (95%LOA) for measurement data was calculated by the Bland-Altman approach.

Result

The Bland-Altman plot showed that the 95% LOA of the differences in the epidermis thickness, dermal thickness, full-thickness skin thickness and split skin thickness was (-15.80 μm to 14.30 μm, P=0.54), (-9.99 μm to 8.59 μm, P=0.36), (-32.33 μm to 32.03 μm, P=0.95 ), and (-33.62 μm to 32.87 μm, P= 0.89), respectively. In this study, the Bland-Altman plot shows that the difference in dermal thickness and the thickness of the split skin calculated by the two methods were all within the 95% LOA. Only one spot representing the difference in dermal thickness was outside the 95% LOA, and one spot representing the difference in full-thickness skin thickness was outside the 95% LOA. Compared with the maximum allowable clinical error range (±10% of the mean thickness of histological measurements), the 95% LOA of the dermal thickness, full-thickness skin thickness and split skin thickness were all within the clinically acceptable range, and the results showed that 95% of the points of the epidermal thickness were within the 95%LOA and within the clinically acceptable range.

Conclusion

A high level of agreement was discovered between high-frequency ultrasound and histology for measuring skin thickness of donor sites. High-frequency ultrasound can provide non-invasive , qucik, accurate and objective measurement for skin thickness, which have promising application in assessing the depth of donor site.

图1 实验工具与操作图示。A示UC22型高频皮肤超声;B示高频超声检测正常皮肤、创面的厚度和结构;C示设计、划分供皮区;D示辊轴取皮刀取皮
图2 SD大鼠皮肤高频超声图像。A示大鼠正常皮肤:表皮、真皮、皮下筋膜、手动测量线、影像数据;B示超声软件对图像进行处理,显示处理结果;C示皮片覆盖归位图像:断层皮片、正常皮肤;D示去除皮片之后的创面图像:供皮区创面、正常皮肤
图3 不同取皮深度下供皮区大体观和组织病理学图像。A示0.1 mm取皮创面可见均匀分布的点状针尖样出血点;B示0.2 mm取皮创面可见广泛均匀出血点,密度远高于前者(图2B);C示0.3 mm取皮后可见创面鲜红,散在较大出血点;D示0.4 mm取皮后创面鲜红,广泛分布较大出血点;E示0.1 mm断层皮片苏木精-伊红染色图;F示0.2 mm断层皮片苏木精-伊红染色图;G示0.3 mm断层皮片苏木精-伊红染色图;H示0.4 mm断层皮片苏木精-伊红染色图
图4 实测数据Bland-Altman散点图。A示表皮厚度Bland-Altman散点图;B示真皮厚度Bland-Altman散点图;C示全层皮肤厚度Bland-Altman散点图;D示断层皮片厚度Bland-Altman散点图
表1 一致性检验Bland-Altman参数分析结果
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