带黑素细胞的组织工程化表皮膜片移植治疗白癜风的初步临床研究  

Transplantation of tissue-engineered epithelial autografts bearing melanocytes for the treatment of vitiligo： a preliminary clinical study

作　　者：李剑[1] 吴文育[1] 陈淑君[1] 傅雯雯[1] 徐金华[1] Taro Uyama 徐昱[1] 项蕾红[1] 

机构地区：[1] 复旦大学附属华山医院皮肤科,上海200040 [2] 日本国立成育医疗中心

出　　处：《中华皮肤科杂志》2015年第3期162-165,共4页Chinese Journal of Dermatology

基　　金：上海市科委引导类课题（124119a1002）;上海市“重中之重”重点学科项目;卫生部重点临床专科项目

摘　　要：目的 评估体外培养含黑素细胞自体表皮膜片移植技术治疗稳定期白癜风的临床有效性和安全性.方法 18 ～ 65岁皮肤科门诊稳定期白癜风患者,切取患者3～ 7.5 cm2正常皮肤组织,根据Green方法进行表皮组织片培养,约3周角质形成细胞形成具有一定张力的表皮片组织,即进行手术移植;术后患处加压包扎,2周后拆线,术后进行随访,并用Wood灯分析色素恢复情况,记录复色情况及不良反应,评价治疗效果.结果 2012年2-12月共入组患者15例,年龄18～62岁,随访时间12～24个月,失访1例.15例白癜风患者中6例达到100％复色,且均为节段型白癜风,6例达到75％～ 100％复色.面颈部患者复色效果优于躯干部位.结论 体外培养含黑素细胞的自体组织工程化表皮膜片移植技术用于治疗稳定期白癜风的安全性、有效性都较高,值得临床应用.Objective To evaluate the clinical efficacy and safety of transplantation of cultured epithelial autografts bearing melanocytes for the treatment of stable vitiligo.Methods Fifteen patients aged 18-65 years with stable vitiligo were enrolled into this study from February to December in 2012.Normal skin tissues measuring 3-7.5 cm2 in size were harvested from these patients.According to the method described by Green,epidermal cells from these tissues were cultivated in vitro.After about 3 weeks of culture,keratinocytes formed epidermal grafts with some tension,which were subjected to autologous transplantation followed by compression bandaging.The sutures were removed after 2 weeks.Follow-up was carried out after transplantation.Repigmentation was analyzed by Wood＆#39;s lamp,and adverse reactions were recorded.Results During the 12-24 months of follow-up,1 patient was lost to follow up.Among the 15 patients with vitiligo,6 with segmental vitiligo achieved 100% repigmentation,and another 6 achieved 75%-100% repigmentation.Lesions on the face and neck showed better repigmentation than those on the trunk after the transplantation.Conclusion Transplantation of cultured tissue-engineered epithelial autografts bearing melanocytes is effective and safe for the treatment of stable vitiligo,and worthy of clinical application.

关 键 词：白癜风 黑素细胞 组织工程 移植 自体 器官培养技术 修复外科手术 皮肤移植 

分 类 号：R758.41[医药卫生—皮肤病学与性病学]