孫兆霞 崔春紅
[摘要]目的:測(cè)量漢族青年女性唇部軟組織正常值,探討唇部軟組織正常值間相關(guān)性以及與面型的關(guān)系。方法:選擇2012~2013級(jí)在校女學(xué)生(共70名,年齡18~19歲;均為漢族),采用面部軟組織直接測(cè)量口唇各部高度均值、口列寬度均值、正面三庭均值、面寬均值、形態(tài)面高和容貌面高均值、內(nèi)眥距離均值。結(jié)果:面部軟組織直接測(cè)量獲得口唇各部高度均值(唇高:3.45±0.608、上唇高:1.95±0.317、上白唇高:1.29±0.326、上紅唇高:0.67±0.201、下唇高:1.55±0.349、下白唇高:0.79±0.336、下紅唇高:0.77±0.199、上下紅唇高:1.48±0.297)cm、口列寬度均值(4.37±0.341)cm、正面三庭均值(上庭:5.92±0.770、中庭:5.75±0.427、下庭6.07±0.607)cm、面寬均值(14.40±1.174)cm、形態(tài)面高(11.85±1.144)cm和容貌面高(18.59±1.234)cm均值、內(nèi)眥距離均值(3.32±0.339)cm。結(jié)論:①建立青年女性口唇形態(tài)測(cè)量相關(guān)指標(biāo)的正常參考值;②口裂寬與內(nèi)眥距離(P=0.005)、上唇高(P=0.000)、唇高(P=0.007)有正相關(guān)(P<0.01),唇形態(tài)改變的趨勢(shì)是越厚越寬,越窄越??;③上唇高(P=0.043)、下唇高(P=0.004)和唇高(P=0.011)與上庭有正相關(guān);④唇高與唇各部高度(除下紅唇高無(wú)相關(guān))均呈正相關(guān),且與上唇高和下唇高相關(guān)性顯著(P=0.000);上唇高與唇各部高度(除下白唇高無(wú)相關(guān))均呈正相關(guān),且與上紅唇高、上下紅唇高、上白唇高及唇高相關(guān)性顯著(P=0.000),而與下紅唇高有相關(guān)性(P=0.002),且上紅唇高對(duì)上唇高影響較上白唇高影響大;下唇高與下白唇高(P=0.000)、唇高(P=0.000)相關(guān)性顯著,頦唇溝位置對(duì)下唇高度影響大;上紅唇高與上下紅唇高相關(guān)性顯著(P=0.000);(P<0.01);⑤唇各部高度和寬度與容貌面高、形態(tài)面高和面寬無(wú)相關(guān)性(P>0.05)。⑥以上唇形態(tài)正常參考值及相關(guān)性對(duì)整形外科提供形態(tài)學(xué)基礎(chǔ)。
[關(guān)鍵詞]口唇;軟組織;形態(tài)測(cè)量
[中圖分類號(hào)]R783.5 [文獻(xiàn)標(biāo)識(shí)碼]A [文章編號(hào)]1008-6455(2014)20-1717-04
Study on relation between the lip shape and facial profile in Han nationality young females
SUN Zhao-xia,CUI Chun-hong
(1.Department of Anatomy,Shandong Wanjie Medical School,Zibo 255213,Shandong,China)
Abstract: Objective Evaluated relationship with lips soft tissue and facial profile in normal young normal,measure the normal values of lip soft tissue. Methods A sample of 2012~2013 grade students (female,70, age 18~19 years old, the Han nationality) was obtained.The mean height of lips, lips width mean,positive three Court mean, morphological facial height,width of face, feature high mean value,internal the angular distance mean were obtained with facial soft tissue directly measured. Results The mean values of lips soft tissue obtained from this sample, these mean values were about lips height:(3.45±0.608)cm,labrum height:(1.95±0.317) cm, upper skin lips height:(1.29±0.326)cm, upper vermilion border height:0.67±0.201 cm, lower lips height:(1.55±0.349)cm, lower skin lips height:0.79±0.336, upper vermilion border height:(0.77±0.199)cm, upper lower vermilion border height:(1.48±0.297)cm,lips width :(4.37±0.341)cm,upper facial height: (5.92±0.770)cm, middle facial height:(5.75±0.427)cm, lower facial height:(6.07±0.607)cm,width of face:14.40±1.174cm, morphological facial height:(11.85±1.144)cm, feature high mean value:(18.59±1.234)cm, internal the angular distance:(3.32±0.339)cm. Conclusion The mean values of lip soft tissue were defined in normal reference young female;Many of reference values have correlated positively (P<0.01), which were embodied between the lips width and inner canthal distance (P=0.005),upper lips high (P=0.000), lips height (P=0.007).The changing trend of lip morphology was more thick, more wide and more narrow, more thinner. The positive correlation were between the upper lips high (P=0.043), lower lips height (P=0.004), the lips height (P=0.011) and upper facial height. Between lips height and the height of every lips except the lower lips high no related were positive correlation, it was significant positive correlation with the upper lips and the lower lips height (P=0.000). Between upper lips height and the height of every lips except the lower skin lips high no related were positive correlation,it was significant positive correlation with the upper lips height and upper vermilion border height, upper lower vermilion border height, the upper skin lips height,the lips height(P=0.000), the lower lips height (P=0.002), the upper vermilion height impacted on upper lips height were more greater than the upper skin lips height.It was significant positive correlation with the lower lips height and lower skin height (P=0.000),lips height (P=0.000), the mentolabial sulcus position affected on the lower lips height. It was significant positive correlation with the upper vermilion height and lower upper vermilion height (P=0.000).It was not related between height, width of lips and feature height, morphological facial height, width (P>0.05).It provided morphological basis for plastic surgery according to the values of lip soft tissue and the correlation of the normal reference values.
Key words:lip;soft tissue;morphometry
顏面瞬息萬(wàn)變的表情受唇活動(dòng)的影響較大,面貌的魅力取決于唇形態(tài)[1]。唇部軟組織形態(tài)正常參考值對(duì)于整形外科和頜面外科的手術(shù)成功與否可以提供客觀的評(píng)價(jià)指標(biāo)[1-2]。因此,本研究通過(guò)對(duì)正常青年女性唇與面形態(tài)特征的分析,為整形外科、頜面外科治療制定的提供參考依據(jù)。
1 資料和方法
1.1 一般資料:選擇2012~2013級(jí)在校女學(xué)生共70名,年齡18~19歲[1-4];均為漢族。五官端正、無(wú)面部畸形及整容史。
1.2 測(cè)量方法及要求:游標(biāo)卡尺(精確到0.02mm)直接測(cè)量。安靜室內(nèi)自然光線,測(cè)試者取坐位,頭位于Frankfort平面且與地面平行,顯示正常發(fā)際線及雙側(cè)等大耳郭、雙目平視正前方、上下唇自然閉合[1,5-7]。
1.3測(cè)量軟組織標(biāo)記點(diǎn)[5-8]如圖1。
1.4 測(cè)量項(xiàng)目見表1。
1.5統(tǒng)計(jì)學(xué)分析:采用SPSS 17統(tǒng)計(jì)軟件進(jìn)行測(cè)量項(xiàng)目的相關(guān)分析,計(jì)量資料均已采用x±s表示, P<0.05為差異具有統(tǒng)計(jì)學(xué)意義。
2 結(jié)果
本研究通過(guò)直接測(cè)量,觀察上下唇白唇和紅唇的形態(tài)特點(diǎn)。唇和面部形態(tài)的各項(xiàng)測(cè)量指標(biāo)均值(見表1),各測(cè)量指標(biāo)相關(guān)研究(見表2)。研究所見:口裂寬與內(nèi)眥距離、上唇高、唇高具有正相關(guān);而上唇高、下唇高和唇高與正面三庭中上庭與具有正相關(guān);唇各部高度和寬度與容貌面高、形態(tài)面高和面寬無(wú)相關(guān)性(見表3);唇各部高度兩兩相關(guān)性比較結(jié)果R2在45%以上如下(如圖2):
2.1 唇高與上唇高和下唇高相關(guān)性顯著,回歸方程:①上唇高與唇高Y=0.810+1.354X, R2=0.499;②唇高與下唇高Y=1.373+1.370X R2=0.724,其中唇高受下唇高影響顯著。
2.2 上唇高與上紅唇高、上下紅唇高、上白唇高及唇高相關(guān)性顯著,回歸方程:③上唇高與上下紅唇高Y=0.146+0.684X, R2=0.534;④上唇高-上白唇高Y=1.039+0.707X,R2=0.528;⑤上唇高-上紅唇高Y=1.178+1.161X,R2=0.542;其中上唇高受上紅唇高影響顯著其他各項(xiàng)。
2.3 下唇高與下白唇高、唇高相關(guān)性顯著,回歸方程:⑥下白唇高-下唇高Y=0.912+0.802X,R2=0.604,其中下唇高受唇高影響顯著;
2.4 上紅唇高與上下紅唇高相關(guān)性顯著,回歸方程:⑦Y=0.740+1.113X,R2=0.568。
3 討論
3.1 Moreira[3]等研究不同年齡的青少年(7、11、18歲,男女性)單側(cè)完全性唇腭裂術(shù)后,鼻唇軟組織發(fā)育不平衡,上唇短、下唇長(zhǎng),唇形態(tài)高度失協(xié)調(diào),因此,唇腭裂患者在術(shù)后出現(xiàn)的繼發(fā)鼻唇畸形需要進(jìn)行修復(fù),而修復(fù)及后期效果的評(píng)估需要有正常參考值[1-2]。本研究對(duì)18~19歲[1-4]在校學(xué)生的唇形態(tài)進(jìn)行相關(guān)分析,研究所見口列寬與唇高(Y=3.431+0.272X,R2=0.234,P=0.007)和上唇高(Y=3.063+0.670X,R2=0.387,P=0.000)呈現(xiàn)正相關(guān),體現(xiàn)唇形態(tài)改變的趨勢(shì)是越厚越寬,越窄越??;口裂寬與內(nèi)眥距離(Y=2.731+0.487X,R2=0.264,P=0.005)呈現(xiàn)正相關(guān),因此,口唇形態(tài)修復(fù)手術(shù)可參考口裂寬度。
同時(shí)本研究上唇高與唇各部高度(除下白唇高無(wú)相關(guān))均呈正相關(guān),且與上紅唇高、上下紅唇高、上白唇高及唇高相關(guān)性顯著(P=0.000),而與下紅唇高有相關(guān)性(P=0.002),且上紅唇高對(duì)上唇高影響較上白唇高影響大;上唇高與上紅唇高關(guān)系顯著于上唇高與上白唇高關(guān)系,體現(xiàn)上紅唇高對(duì)上唇高影響大。與高興等[1]測(cè)得女性組唇高值(中全上唇高與全下唇高、低點(diǎn)上唇紅高與下唇紅高各成對(duì)指標(biāo)間不存在密切相關(guān)性)略有不同。而唇高與下唇高相關(guān)性顯著于唇高與上唇高的相關(guān)性。并且下唇高受下白唇高影響顯著,與高興等[1]測(cè)得女性組唇高值相同。下白唇高下界為頦唇溝點(diǎn),說(shuō)明下白唇高受頦唇溝相對(duì)位置影響大。
面部正面形態(tài)參考值可見上庭的高度與下唇高(Y=5.009+0.846X,R2=0.267,r=0.004)、下庭高(Y=3.844+0.393X,R2=0.158,p=0.016)都有相關(guān)性,而下庭高主要是唇高與頦高之和,恢復(fù)下唇高要參考上庭高。下庭高與容貌面高相互影響(P=0.022),而上、中庭對(duì)容貌面高影響不顯著,可見面下部1/3形態(tài)變化較大。
本研究與祖青[9-10]等研究的中國(guó)美貌漢族女性面下形態(tài)比例對(duì)比可見(括號(hào)內(nèi)數(shù)值為祖青等研究結(jié)果),上唇高/下頦唇高49%(1:2);頦高/下唇頦高63%(62%);上白唇高/上唇高68%(66%)上唇紅唇高度/上唇高35%(40%);下白唇高度/下唇高50%(52%);下唇紅唇高度/下唇高52%(68%)本研究對(duì)象唇的形態(tài)特點(diǎn)參考值多數(shù)符合審美要求。
唇各部高度和寬度與容貌面高、形態(tài)面高和面寬無(wú)相關(guān)性(P>0.05),體現(xiàn)唇形態(tài)不受面型影響。本研究選取的對(duì)象是有地域差別的在校學(xué)生,目的使唇形態(tài)指標(biāo)量化的基礎(chǔ)上,更能真實(shí)反映18~19歲青年女生情況,為整形美容或治療提供客觀參考依據(jù)。
[參考文獻(xiàn)]
[1]高興,翦新春,吳曉珊,等.漢族青年口唇形態(tài)及相關(guān)指標(biāo)測(cè)量的研究[J].中國(guó)美容整形外科雜志,2010,21(5):263-267.
[2]Theodosia Bartzela,Christos Katsaros ,Elisabeth R?nning, etal. A longitudinal three-center study of craniofacial morphology at 6 and 12 years of age in patients with complete bilateral cleft lip and palate[J].Clin Oral Invest,2012,16:1313-1324.
[3]Moreira I,Suri S,Ross B,et al. Soft-tissue profile growth in patients with repaired complete unilateral cleft lip and palate:A cephalometric comparison with normal controls at ages 7, 11, and 18 years[J].Am J Orthod Dentofacial Orthop, 2014,145(3):341-358.
[4]李彩,呂運(yùn)成,范松青.正常成人唇外形的測(cè)量觀察與美學(xué)研究[J].中國(guó)美容整形外科雜志, 2014,25(1):54-56.
[5]孫兆霞,程輝,崔春紅.正常青年女性面?zhèn)炔寇浗M織美學(xué)特征的研究[J].中國(guó)美容整形外科雜志, 2014,25(3):164-167.
[6]孟慶蘭.口唇及頦部相關(guān)性研究[J].中國(guó)美容整形外科雜志,2007,18(3):175-177.
[7]Jan Rustemeyer,Alice Martin. Soft tissue response in orthognathic surgery patients treated by bimaxillary osteotomy: cephalometry compared with 2-D photogrammetry[J].Oral Maxillofac Surg,2013,17:33-41.
[8]孫兆霞,崔春紅.FreeHand MX在正常青年人側(cè)面分析研究中的應(yīng)用[J].中國(guó)美容醫(yī)學(xué),2013,22(21):2140-2143.
[9]祖青,米叢波,宋美云,等.中國(guó)美貌漢族女性面下1/3 軟組織側(cè)貌比例的研究[J].中國(guó)美容醫(yī)學(xué),2011,20(3):460-462.
[10]祖青,米叢波,聶晶,等.中國(guó)美貌女性頦部軟組織形態(tài)的比例分析[J].中國(guó)組織工程研究與臨床康復(fù),15(22):4065-4068.
[收稿日期]2014-04-22 [修回日期]2014-06-10
編輯/何志斌