他克莫司软膏联合308准分子光治疗寻常型白癜风及对外周血CD4^+/CD8^+、IL-17、IL-22的影响  

Tacrolimus Ointment Combined with 308 Excimer Laser in the Treatment of Vitiligo Vulgaris and its Effect on Peripheral Blood CD4^+/CD8^+,IL-17,IL-22

作　　者：钱俐 缪亚军 余珊珊 QIAN Li;MIAO Ya-jun;YU Shan-shan(Department of Dermatology,Nantong Tongzhou People's Hospital,Nantong 226300,Jiangsu,China)

机构地区：[1]南通市通州区人民医院皮肤科,江苏南通226300

出　　处：《中国美容医学》2021年第1期82-85,共4页Chinese Journal of Aesthetic Medicine

摘　　要：目的:观察他克莫司软膏联合308准分子光治疗寻常型白癜风的临床观察及对患者外周血中T细胞亚群及血清中IL-17、IL-22水平的影响。方法:选择2014年12月-2016年12月在南通市通州区人民医院检查的白癜风患者85例,根据随机数字法将患者分为对照组和治疗组,对照组采用308准分子光常规治疗,治疗组在308准分子光治疗基础上加用0.1%他克莫司软膏,比较各组患者治疗前后的临床症状及外周血中T细胞亚群及血清中IL-17、IL-22的水平。结果:治疗组总有效率为95.35%,显著高于对照组的80.95%,差异有统计学意义(P<0.05)。两组患者治疗后,外周血中CD3^+、CD4^+、CD4^+/CD8^+的水平均显著升高,差异有统计学意义(P<0.05)。治疗组CD3^+、CD4^+、CD4^+/CD8^+的水平分别为(69.37±3.58)%、(38.93±2.11)%、1.56±0.16,对照组分别为(67.24±3.92)%、(37.42±2.17)%、1.41±0.18,两组CD3^+、CD4^+水平比较差异无统计学意义(P>0.05),CD4^+/CD8^+比较差异有统计学意义(P<0.05)。两组患者治疗后,血清中IL-17、IL-22的水平均显著下降,差异有统计学意义(P<0.05)。治疗后,治疗组血清中IL-17、IL-22的水平分别为(29.36±3.29)pg/ml、(20.37±2.61)pg/ml,均显著低于对照组的(33.54±4.21)pg/ml、(28.57±2.48)pg/ml,差异有统计学意义(P<0.05)。两组患者均出现皮肤瘙痒、水疱、灼烧感、红斑等不良反应,两组不良反应发生率比较差异无统计学意义(P>0.05)。结论:他克莫司软膏联合308准分子光治疗寻常型白癜风的疗效确切,可降低患者血清中IL-17、IL-22的水平,升高外周血中CD3^+、CD4^+、CD4^+/CD8^+的水平。Objective To observe the effect of tacrolimus ointment combined with 308 excimer laser on vitiligo vulgaris and the peripheral blood T cell subsets,IL-17 and IL-22.Methods 85 patients with vitiligo vulgaris diagnosed by Nantong Tongzhou District People's Hospital from December 2014 to December 2016 were slected.The patients were divided into the control group and the treatment group randomly.The control group was treated with 308 excimer laser routine treatment,and the treatment group was treated with 0.1%tacrolimus ointment and 308 excimer laser therapy.The levels of T-cell subsets,IL-17 and IL-22 in serum were determined.Results The total effective rate was 95.35%in the treatment group,which was significantly higher than that in the control group(80.95%),the difference was statistically significant(P<0.05).The levels of CD3^+,CD4^+,CD4^+/CD8^+in serum in two groups were significantly increased after treatment(P<0.05).After the treatment,the levels of CD3^+,CD4^+,CD4^+/CD8^+in the treatment group were(69.37±3.58)%,(38.93±2.11)%and 1.56±0.16,and those of the control group were(67.24±3.92)%,(37.42±2.17)%,1.41±0.18.The blood levels of CD3^+and CD4^+were not significantly different between the two groups(P>0.05),and there was a significant difference in the levels of CD4^+/CD8^+(P<0.05).After treatment,the level of IL-17 and IL-22 of the treatment group were(29.36±3.29)pg/ml and(20.37±2.61)pg/ml,which were significantly lower than those of the control group[(33.54±4.21)pg/ml and(28.57±2.48)pg/ml,P<0.05].Adverse reactions in two groups were pruritus,blisters,burning sensation and erythema,and there were no significant differences in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Tacrolimus ointment combined with 308 excimer laser treatment of vitiligo vulgaris was effective,it can reduced the serum levels of IL-17 and IL-22 and increase the blood levels of CD3^+,CD4^+,CD4^+/CD8^+.

关 键 词：寻常型白癜风 他克莫司软膏 308准分子光 疗效 CD4^+/CD8^+ IL-17 IL-22 

分 类 号：R758.41[医药卫生—皮肤病学与性病学]