308 nm准分子激光联合0.1%他克莫司软膏对稳定期寻常型局限性白癜风患者免疫水平和黑色素细胞刺激素的影响  

Clinical effects observation of 308 nm excimer laser combined with 0.1% tacrolimus ointment on immune level and melanocytes in patients with stable localized vitiligo vulgaris

作　　者：王岚 刘东斌 Wang Lan;Liu Dongbin(Department of Dermatology,General Hospital of Jinshui District Zhengzhou City,Zhengzhou,Henan 450000,China;Department of Oncology,Henan Provincial People's Hospital,Zhengzhou,Henan 450000,China)

机构地区：[1]郑州市金水区总医院皮肤科,河南郑州450000 [2]河南省人民医院肿瘤科,河南郑州450000

出　　处：《感染．炎症．修复》2022年第3期158-161,共4页Infection Inflammation Repair

摘　　要：目的:探讨308nm准分子激光联合0.1%他克莫司软膏治疗稳定期寻常型局限性白癜风对细胞间黏附因子-1(ICAM-1)、黑素细胞刺激素(α-MSH)以及外周血T细胞亚群水平的影响。方法:郑州市金水区总医院皮肤科2018年10月—2020年8月门诊就诊的105例稳定期寻常型局限性白癜风患者采用随机数字表法分为两组,对照组52例患者采用308nm准分子激光照射皮损部位,每周2次。观察组53例在对照组治疗基础上加用0.1%他克莫司软膏局部涂抹,每日2次。比较两组患者临床效果,病变区域面积,白癜风严重程度评分指数(VASI)变化,ICAM-1、α-MSH和白细胞介素-17(IL-17)水平变化,外周血T细胞亚群变化及治疗的不良反应。结果:治疗后,观察组总显效率,血清α-MSH水平,外周血CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)水平高于对照组,病变区域面积、VASI评分、ICAM-1、IL-17水平低于对照组(P<0.01)。两组不良反应总发生率差异无统计学意义(P>0.05)。结论:0.1%他克莫司软膏联合308 nm准分子激光照射治疗对稳定期寻常型局限性白癜风患者具有显著的治疗效果,可以通过对ICAM-1、α-MSH、外周血T细胞亚群的改善,促进病变面积的缩小,同时具有较高安全性。Objective: To explore the effects of 308 nm excimer laser combined with 0.1% tacrolimus ointment on intercellular adhesion factor-1(ICAM-1), melanocyte stimulating hormone(α-MSH) and peripheral blood T cell subpopulation level in patients with stable localized vitiligo vulgaris. Methods: From Oct. 2018 to Aug. 2020, 105patients with stable localized vitiligo vulgaris were admitted in dermatology clinic in General Hospital of Jinshui District Zhengzhou City, and they were divided into two groups by random number table method. Fifty-two cases in the control group were given 308 nm excimer laser irradiation in the skin lesion area, twice a week, and 53 cases in the observation group were additionally treated with 0.1% tacrolimus ointment(twice a day) on the basis of 308 nm excimer laser treatment. The clinical effects, skin lesion area, vitilogo severity score index(VASI) changes, ICAM-1, α-MSH,interleukin-17(IL-17), peripheral blood T cell subsets viriation and side-effects were compared between the two groups.Results: After treatment, the total effective rate, α-MSH level, peripheral blood CD3^(+), CD4^(+), CD4^(+)/CD8^(+) levels in the observation group were higher than in the control group, the specific area of the skin lesion area and VASI score, ICAM-1, IL-17 level was lower than in the control group(P<0.01). The incidence of side-effects between the two groups were not statistically significant(P>0.05). Conclusions: 0.1% tacrolimus ointment combined with 308 nm excimer laser irradiation has a significant intervention effect on patients with stable localized vitiligo vulgaris, which can be improved by ICAM-1,α-MSH, and peripheral blood T cell subsets. The area of the skin lesion can be reducted, thereby the recovery effect of the lesion area is improved, which has a higher safety at the same time.

关 键 词：308 nm准分子激光 他克莫司软膏 局限性白癜风 T细胞亚群 

分 类 号：R758.41[医药卫生—皮肤病学与性病学] R616.4[医药卫生—临床医学]