二苯环丙烯酮局部免疫治疗难治性斑秃的疗效分析  

Therapeutic Effects of Topical Immunotherapy with Diphenylcyclopropenone on Refractory Alopecia Areata

作　　者：詹济滂 叶艳婷[1] 薛紫 高雪梅 杨建[1] 章星琪[1] ZHAN Ji-pang;YE Yan-ting;XUE Zi;GAO Xue-mei;YANG Jian;ZHANG Xing-qi(Department of Dermatovenereology,the First Affiliated Hospital of Sun Yat-sen University,Guangzhou 510080,China)

机构地区：[1]中山大学附属第一医院皮肤性病科,广东广州510080

出　　处：《中山大学学报（医学版）》2018年第5期693-701,共9页Journal of Sun Yat-Sen University:Medical Sciences

基　　金：国家自然科学基金(81573066);广东省自然科学基金(2014A030313098);东莞市社会科技发展项目(2014108101022)

摘　　要：【目的】探讨难治性斑秃患者局部外用二苯环丙烯酮(DPCP)的疗效及其影响因素。【方法】回顾性分析127例难治性斑秃患者外用DPCP的有效率、不良反应、复发率和再次治疗的有效率,并分析临床资料、皮肤镜征象、检验指标对疗效的影响。【结果】本组难治性斑秃患者DPCP治疗治愈率、有效率分别为37.1%、44.8%,复发率为36.5%,复发后再治疗有效率为63.2%。26.8%患者出现较明显副作用如严重接触性皮炎、泛发性接触性皮炎、白癜风等。发病年龄早、病程长、稳定期、脱发面积大、斑秃类型为全普秃和带状型、皮肤镜黑点断发征像阴性者疗效差(P值分别是0.016、0.093、0.003、0.031、0.002和0.006)。【结论】外用DPCP治疗难治性斑秃疗效确切且相对安全,尤其是对于脱发面积小、病程短、活动期时治疗效果最佳。但目前DPCP疗法仍待进一步改良,以提高难治性斑秃的有效率。【Objective】To investigate the therapeutic effect of diphenylcyclopropenone(DPCP)topical immunother-apy in refractory alopecia areata(AA)patients and its influencing factors in Chinese population.【Methods】127 refracto-ry and severe alopecia areata patients in Chinese population treated with DPCP were retrospectively analyzed and the influ-ence of clinical manifestations,dermotoscopy signs and laboratory markers on treatment was also investigated.【Results】The curative rate was 37.1%and the response rate 44.8%.However,a relapse rate of 36.5%was observed and the effec-tive rate of treatment after relapse was 63.2%.26.8%of the patients suffered from relatively severe side effects consisting of severe contact dermatitis,systemic contact dermatitis,vitiligo and so on.Effectiveness of treatment correlated negative-ly with early onset age,long disease duration,stable phase,extensive hair loss area,type of alopecia areata universalis or totalis or ophiasis,negative signs of black dots or broken hairs under dermatoscope(P=0.016,0.093,0.003,0.031,0.002,0.006 respectively).【Conclusion】DPCP topical immunotherapy treatment is a relatively safe and effective way in treating refractory and severe AA patients in Chinese population.The best efficacy is achieved especially when hair loss ar-ea is not extensive,short disease course and active phase existing.However,further modified DPCP treatments are urgent-ly needed to improve the response rate.

关 键 词：DPCP 二苯环丙烯酮 局部免疫疗法 难治性斑秃 

分 类 号：R758.71[医药卫生—皮肤病学与性病学]