摘要
目的观察308 nm准分子激光联合他克莫司治疗白癜风患者的临床疗效及对T淋巴细胞亚群的影响。方法选取三门峡市中心医院2019年10月至2022年10月收治的白癜风患者121例,根据随机数字表法分为对照组(他克莫司)58例和观察组(308 nm准分子激光+他克莫司)63例。对比两组临床疗效、T淋巴细胞亚群(CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+))、血清学指标[单核细胞趋化蛋白-1(Monocyte chemotactic protein-1,MCP-1)、可溶性细胞黏附分子-1(Soluble intercellular adhesion molecule-1,sICAM-1)]、炎性因子[白介素-17(Interleukin-17,IL-17)、IL-23]及不良反应。结果观察组临床总有效率高于对照组(P<0.05)。两组干预后CD4^(+)、CD4^(+)/CD8^(+)水平均有所上升,CD8^(+)水平出现下降;且观察组CD4^(+)、CD4^(+)/CD8^(+)水平均显著高于对照组,CD8^(+)水平低于对照组(P<0.05)。两组干预后MCP-1、sICAM-1水平均显著下降,且观察组MCP-1、sICAM-1水平均低于对照组(P<0.05)。两组干预后IL-17、IL-23水平均显著下降,且观察组IL-17、IL-23水平均低于对照组(P<0.05)。两组不良反应差异无统计学意义(P>0.05)。结论308 nm准分子激光联合他克莫司治疗白癜风较他克莫司单独使用治疗临床疗效更好,其作用机制可能与影响T淋巴细胞亚群、sICAM-1及IL-23表达水平有关;无明显不良反应,安全性尚可,具有临床应用价值。
Objective This study aimed to observe the clinical efficacy of 308 nm excimer laser combined with tacrolimus in the treatment of vitiligo and its effect on T lymphocyte subsets.Methods A total of 121 cases of vitiligo patients admitted to our hospital from October 2019 to October 2022 were selected.They were randomly divided into a control group(treated with tacrolimus,58 cases)and an observation group(treated with 308 nm excimer laser+tacrolimus,63 cases).The clinical efficacy,T lymphocyte subsets(CD4^(+),CD8^(+),CD4^(+)/CD8^(+)),serological indicators[monocyte chemotactic protein-1(MCP-1),sICAM-1],Inflammatory factors[Interleukin-17(IL-17),IL-23],and adverse reactions were compared between the two groups.Results The total clinical effective rate of the observation group was higher than that of the control group(P<0.05).After intervention,the levels of CD4^(+)and CD4^(+)/CD8^(+)increased,while the level of CD8^(+)decreased in both groups.The levels of CD4^(+)and CD4^(+)/CD8^(+)in the observation group were significantly higher,and the level of CD8^(+)was lower than those in the control group(P<0.05).After intervention,the levels of MCP-1 and sICAM-1 in the two groups were significantly decreased,and the levels of MCP-1 and sICAM-1 in the observation group were lower than those in the control group(P<0.05).After intervention,the levels of IL-17 and IL-23 in both groups significantly decreased,and the levels of IL-17 and IL-23 in the observation group were lower than those in the control group(P<0.05).There was no statistically significant difference in adverse reactions between the two groups(P>0.05).Conclusion 308 nm excimer laser combined with tacrolimus had better clinical efficacy than tacrolimus alone in the treatment of vitiligo patients.Its mechanism might be related to the influence of T lymphocyte subsets,sICAM-1 and IL-23 expression levels.Moreover,it was relatively safe and held great importance in improving the clinical efficacy of vitiligo.
作者
陈贝贝
兰堃田
李雪莉
焦丹红
高丽娟
漫红
CHEN Beibei;LAN Kuntian;LI Xueli;JIAO Danhong;GAO Lijuan;MAN Hong(Department of Dermatology,Sanmenxia Central Hospital,Sanmenxia 472000,China;Department of Tumor Radiotherapy,Sanmenxia Central Hospital,Sanmenxia 472000,China;Department of Dermatology,Henan Provincial People's Hospital,Zhengzhou 450003,China)
出处
《西南医科大学学报》
2023年第5期424-427,共4页
Journal of Southwest Medical University
基金
河南省医学科技攻关计划项目(201204132)。
作者简介
通信作者:陈贝贝,E-mail:cbb9266@163.com。
