Abstract：
OBJECTIVE: To compare the histopathological findings of patients who had been diagnosed with dermatochalasis (DC) and had undergone upper eyelid blepharoplasty (ULB) as well as those of controls (C-Group) according to their serum vitamin D (SVD) levels.
METHODS: The prospective study included 136 upper eyelid skin from 68 patients who underwent surgery for DC and 53 upper eyelid skin from 53 patients who underwent levator surgery with ULB. The DC Group was then divided into 3 subgroups according to the marginal reflex distance (MRD4). The lymphatic vessel (LV) count and diameter of the largest LV (DLLV) were recorded, the stromal collagen bed (SCB) was observed, and its depth was measured, the interfibrillar edema was examined, and the elastic fiber and macrophage counts and recorded, respectively, and then all of these were evaluated. The SVD levels were compared between the DC patients and the C-Group.
RESULTS: In comparison to the C-Group, significant changes were seen in the dilated LV, DLLV, SCB depth, interfibrillar edema, elastic fiber density, and macrophage count in the DC sub-Groups (P < 0.001 for all). While no difference was found between DC sub-Group 1 (MRD4 > 4 mm) and the C-Group (P > 0.05), a significant difference was found between DC sub-Group 2 (MRD4 2-4 mm) and DC sub-Group 3 (MRD4 < 2 mm) for all of the parameters (P < 0.05). A statistically significant difference was also found in the SVD levels between the DC sub-Group 1 and DC sub-Groups 2-3 (P < 0.017, P < 0.001 respectively).
CONCLUSIONS: According to the results of this study, SVD level was significantly lower in DC group. Moreover, an increased LV count and diameter, decreased elastic fiber count, collagen fiber and stromal edema irregularity, and increased macrophage count were found to be associated with the SVD level.
METHODS: The prospective study included 136 upper eyelid skin from 68 patients who underwent surgery for DC and 53 upper eyelid skin from 53 patients who underwent levator surgery with ULB. The DC Group was then divided into 3 subgroups according to the marginal reflex distance (MRD4). The lymphatic vessel (LV) count and diameter of the largest LV (DLLV) were recorded, the stromal collagen bed (SCB) was observed, and its depth was measured, the interfibrillar edema was examined, and the elastic fiber and macrophage counts and recorded, respectively, and then all of these were evaluated. The SVD levels were compared between the DC patients and the C-Group.
RESULTS: In comparison to the C-Group, significant changes were seen in the dilated LV, DLLV, SCB depth, interfibrillar edema, elastic fiber density, and macrophage count in the DC sub-Groups (P < 0.001 for all). While no difference was found between DC sub-Group 1 (MRD4 > 4 mm) and the C-Group (P > 0.05), a significant difference was found between DC sub-Group 2 (MRD4 2-4 mm) and DC sub-Group 3 (MRD4 < 2 mm) for all of the parameters (P < 0.05). A statistically significant difference was also found in the SVD levels between the DC sub-Group 1 and DC sub-Groups 2-3 (P < 0.017, P < 0.001 respectively).
CONCLUSIONS: According to the results of this study, SVD level was significantly lower in DC group. Moreover, an increased LV count and diameter, decreased elastic fiber count, collagen fiber and stromal edema irregularity, and increased macrophage count were found to be associated with the SVD level.
摘要：
目的：根据血清维生素D（SVD）水平，比较被诊断为皮肤松弛症（DC）并接受上眼睑成形术（ULB）的患者和对照组（C组）的组织病理学发现。
方法：前瞻性研究包括来自68例接受DC手术的患者的136个上眼睑皮肤和来自53例接受ULB提肌手术的患者的53个上眼睑皮肤。然后根据边缘反射距离（MRD4）将DC组分为3个亚组。记录淋巴管（LV）计数和最大LV（DLLV）的直径，观察到基质胶原床（SCB），测量了它的深度，检查了纤维间水肿，弹性纤维和巨噬细胞计数并记录，分别,然后对所有这些进行了评估。比较DC患者和C组的SVD水平。
结果：与C组相比，在扩张的LV中看到了显著的变化，DLLV,SCB深度,纤维间水肿,弹性纤维密度，和DC亚组的巨噬细胞计数(全部P<0.001)。DC亚组1(MRD4>4mm)与C组比较差异无统计学意义(P>0.05),DC亚组2(MRD42~4mm)和DC亚组3(MRD4<2mm)的所有参数均存在显著差异(P<0.05).在DC亚组1和DC亚组2-3之间的SVD水平中也发现了统计学上的显着差异（分别为P<0.017，P<0.001）。
结论：根据本研究的结果，DC组SVD水平明显降低。此外，LV计数和直径增加，弹性纤维计数减少，胶原纤维和基质水肿不规则，巨噬细胞计数增加与SVD水平相关。
方法：前瞻性研究包括来自68例接受DC手术的患者的136个上眼睑皮肤和来自53例接受ULB提肌手术的患者的53个上眼睑皮肤。然后根据边缘反射距离（MRD4）将DC组分为3个亚组。记录淋巴管（LV）计数和最大LV（DLLV）的直径，观察到基质胶原床（SCB），测量了它的深度，检查了纤维间水肿，弹性纤维和巨噬细胞计数并记录，分别,然后对所有这些进行了评估。比较DC患者和C组的SVD水平。
结果：与C组相比，在扩张的LV中看到了显著的变化，DLLV,SCB深度,纤维间水肿,弹性纤维密度，和DC亚组的巨噬细胞计数(全部P<0.001)。DC亚组1(MRD4>4mm)与C组比较差异无统计学意义(P>0.05),DC亚组2(MRD42~4mm)和DC亚组3(MRD4<2mm)的所有参数均存在显著差异(P<0.05).在DC亚组1和DC亚组2-3之间的SVD水平中也发现了统计学上的显着差异（分别为P<0.017，P<0.001）。
结论：根据本研究的结果，DC组SVD水平明显降低。此外，LV计数和直径增加，弹性纤维计数减少，胶原纤维和基质水肿不规则，巨噬细胞计数增加与SVD水平相关。
