摘要目的:探讨高原不同海拔地区儿童面部皮肤状况。方法:该研究为横断面调查。2022年6月至2024年2月，昆明医科大学第一附属医院皮肤科招募327名6～12岁儿童，其中男164名，年龄(9.97±2.56)岁，女163名，年龄(10.23±2.05)岁。分别来自6个不同的海拔地区，永仁组(海拔1 500 m)76名、昆明组(海拔1 800 m)63名、美姑组(海拔2 000 m)21名、大山包组(海拔3 100 m)34名、拉市海组(海拔3 500 m)64名、日喀则组(海拔3 800 m)69名。收集儿童面部皮肤特征，用无创仪器测量儿童左侧脸颊的经表皮失水率、角质层含水量、皮肤明亮度(L值)、皮肤红度(a值)。从中国知网、中国气象数据服务中心、美国国家海洋和大气管理局数据库获取6个不同海拔地区的气象数据，包括月平均气温、月平均湿度、年日照时长。结果:327名儿童中，排名前5位的皮肤病检出率依次是毛细血管扩张症270例(82.57%)、雀斑173例(52.91%)、色素痣125例(38.23%)、白色糠疹98例(29.97%)、瘢痕93例(28.44%)。高原地区轻度脱屑134名(40.98%)、中度脱屑64名(19.57%)、重度脱屑25名(7.65%)。6个地区总体经表皮失水率为(6.55±3.95) g·m -2·h -1，角质层含水量为(24.19±19.45) au，L值为(51.76±4.31) au，a值为(15.60±2.29) au。其中，高海拔段大山包组经表皮失水率高于其他5组( F＝18.76, P<0.05)，拉市海组和日喀则组角质层含水量分别高于其他4组( F＝157.29, P<0.05)，美姑组L值分别低于其余5组( F＝14.06, P<0.05)，昆明组a值低于其余5组( F＝11.88, P<0.05)。 结论:高原不同海拔地区儿童面部皮肤屏障功能差异显著，均存在不同程度的功能受损。

abstractsObjective:To explore the skin conditions, skin diseases, and physiological functions of the facial skin in plateau children.Methods:It was a cross-sectional study. A total of 327 children aged 6-12 years which included 164 males (9.97±2.56 years) and 163 females (10.23±2.05 years) were recruited in this study from six different altitude groups from June 2022 to February 2024 at the Department of Dermatology, the First Affiliated Hospital of Kunming Medical University: Yongren group, Kunming group, Meigu group, Dashanbao group, Lashihai group, and Rikaze group at altitudes of 1 500, 1 800, 2 000, 3 100, 3 500, and 3 800 m. and 76, 63, 21, 34, 64, and 69 children were recruited from each group, respectively. The facial skin characteristics and the transepidermal water loss, stratum corneum hydration, the L * value, and the a * value, which were tested by non-invasive instruments, were collected. Subsequently, meteorological data for the six locations were obtained from CNKI and China Meteorological Data Service Centre, including monthly temperature, monthly humidity, and annual sunshine duration. Finally, all data were analyzed using SPSS 29.0. Results:The top five facial skin diseases in 327 children were telangiectasia (249, 82.57%), freckles (173, 52.91%), nevus (125, 38.23%), pityriasis alba (98, 29.97%), and scars (93, 28.44%). In addition, a total of 15 cases of melasma with a lower score of mMASI were identified in this study. In all the subjects, 7.65% had severe desquamation, 19.57% had moderate desquamation, and 40.98% had mild desquamation. The whole transepidermal water loss value of highland children＇s face was (6.55±3.95) g·m -2·h -1, the stratum corneum hydration value was (24.19±19.45) au, the L * value was (51.76±4.31) au, the a * value was (15.60±2.29) au. The Dashanbao group was higher than the other 5 groups ( F=18.76, P<0.05), and the stratum corneum hydration of the Lashihai and Rikaze groups was higher than any other groups ( F=157.292, P<0.05), the L * value of the Meigu group was the lowest in any other 5 groups ( F=14.06, P<0.05), the a * value of the Kunming group was lower than other all groups ( F=11.88, P<0.05). Conclusions:The proportion of facial skin diseases varies slightly across altitudes, with significant differences in skin barrier function among the six groups of children with impaired skin barrier function in the highlands.