中华皮肤科杂志 ›› 2008, Vol. 41 ›› Issue (10): 657-659.

• 论著 • 上一篇    下一篇

白癜风自体表皮移植处内皮素与干细胞因子的检测

陈惠英 关翠萍 郑冬娣 樊奇敏 许爱娥   

  1. 杭州市第三人民医院皮肤科 杭州市第三人民医院皮肤科 杭州市第三人民医院皮肤科
  • 收稿日期:2007-12-03 修回日期:2008-03-22 发布日期:2008-10-15
  • 通讯作者: 陈惠英 E-mail:chenhuiying58@163.com

Determination of endothelin and stem cell factors in epidermal tissue fluid at the donor site and recipient site in patients with vitiligo receiving autologous epidermal grafting

  

  • Received:2007-12-03 Revised:2008-03-22 Published:2008-10-15

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摘要： 目的 探讨白癜风自体表皮移植的疗效与局部细胞因子变化的相关性。方法 对稳定期白癜风患者进行负压吸疱移植治疗，部分患者移植前白斑曾进行窄谱中波紫外线照射，共57例患者成功收集到白斑及非白斑区疱液，并完成3个月随访，判断其疗效，其中照光者17例。用ELISA方法测定皮肤组织液中内皮素-1、干细胞因子的水平。结果 白斑区与非白斑区组织液自身对照比较，移植成功患者45例白斑区皮肤组织液内皮素-1、干细胞因子浓度分别为（728.97 ± 286.12） ng/L、（329.97±114.13） ng/L，非白斑区分别为（503.16 ± 251.44） ng/L、（224.73 ± 107.91） ng/L，白斑区与非白斑区比较，t值分别为5.44、5.90，P < 0.05。12例移植失败患者白斑区干细胞因子为（309.00 ± 163.89） ng/L，非白斑区为（204.22 ± 83.25） ng/L，两组比较，t ＝ 3.03，P < 0.05；而内皮素-1两组差异无统计学意义。移植成功患者在白斑区与非白斑区内皮素-1浓度明显高于移植失败患者，分别为（507.52 ± 283.31） ng/L和（344.91 ± 156.18） ng/L，t值分别为2.39，2.70，P < 0.05，干细胞因子浓度差异则无统计学意义。紫外线照射患者白斑区内皮素-1浓度与未照光患者比较，t ＝ 1.44，P > 0.05。在移植成功者中，行紫外线照射的15例内皮素-1为（548.48 ± 230.22） ng/L，未照光组为（794.60 ± 278.72） ng/L（P < 0.05）；干细胞因子浓度差异则无统计学意义。结论 内皮素-1、干细胞因子在白癜风的色素恢复中起作用，其中内皮素-1的作用可能更为重要。

关键词: 白癜风;内皮素-1;干细胞因子;皮肤组织液;移植, 表皮

Abstract: Objective To investigate the relationship between the efficacy of autologous epidermal grafting and the levels of epidermal cytokines in vitiligo. Methods A total of 57 patients with stable vitiligo receiving autologous epidermal grafting were included in this study. Before grafting, 17 patients were irradiated with narrow-band UVB on vitiliginous sites. Suction blister fluid was collected from the recipient site （vitiligous lesions） and donor site （normal skin） in these patients （including the 17 patients irradiated with NB-UVB）. ELISA was used to detect the levels of endothelin-1 （ET-1） and stem cell factors （SCF） in suction blister fluid. Clinical efficacy was evaluated through a 3-month follow-up. Results Among these 57 patients, 45 successfully responded to autologous epidermal grafting. In these 45 patients, the levels of ET-1 and SCF in vitiligous lesions were 728.97 ± 286.12 ng/L and 329.97 ± 114.13 ng/L respectively, significantly higher than those in nomal skin （503.16 ± 251.44 ng/L, 224.73 ± 107.91 ng/L, t = 5.443, 5.897, respectively, both P < 0.05）. In those who responded poorly, significant difference was also observed in the level of SCF between the normal skin and vitiligous lesions （309.00 ± 163.89 ng/L vs 204.22 ± 83.25 ng/L, t = 3.03, P < 0.05), but not in the level of ET-1. Increased level of ET-1 was observed in both vitiligous lesions and normal skin of patients who responded well compared to those who responded poorly, while no difference was noticed in the level of SCF between these two groups of patients. The level of ET-1 was statistically higher in vitiligous lesions in patients exposed to NB-UVB than in those without exposure （t = 1.44, P > 0.05）. In those patients who responded successfully, the level of ET-1 was lower in the 15 patients exposed to NB-UVB compared to the other 30 patients without exposure （548.48 ± 230.22 ng/L vs 794.60 ± 278.72 ng/L, P < 0.05）; no significant difference in the level of SCF was noted. Conclusions ET-1 and SCF may both play important roles in the repigmentation of vitiligo, with ET-1 exerting a more important role.

Key words: Vitiligo, Endothelin-1, Stem cell factor, Skin tissue fruit, Graft,epidermal