中华皮肤科杂志 ›› 2013, Vol. 46 ›› Issue (4): 235-238.

• 论著 • 上一篇    下一篇

自体黑素细胞移植治疗白癜风细胞接种量与疗效关系的研究

洪为松1,傅丽芳2,尉晓冬1,钱国培1,许爱娥3   

  1. 1. 杭州市第三人民医院
    2.
    3. 安徽医科大学附属杭州市第三人民医院皮肤科
  • 收稿日期:2012-03-01 修回日期:2012-12-21 出版日期:2013-04-15 发布日期:2013-04-01
  • 通讯作者: 许爱娥 E-mail:xuaiehz@msn.com
  • 基金资助:
    浙江省科技厅重大科技专项国际合作项目;杭州市科技局基金

Optimization of cell seeding density in the treatment of vitiligo by transplantation of cultured autologous melanocytes

  • Received:2012-03-01 Revised:2012-12-21 Online:2013-04-15 Published:2013-04-01

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摘要： 目的 研究自体黑素细胞移植治疗白癜风细胞接种量与疗效的关系。方法 共移植治疗632例稳定期白癜风患者，采用随机分组的方法分为4组，其中201例患者黑素细胞接种量为（3.0 ~ 4.9） × 104个/cm2，303例接种量为（5.0 ~ 7.9） × 104个/cm2，82例接种量为（8.0 ~ 9.9） × 104个/cm2和46例接种量为（10.0 ~ 12.0） × 104个/cm2。负压吸疱获取患者正常表皮片，Hu16培养基体外培养黑素细胞，经2 ～ 5代体外培养，受皮区应用超脉冲CO2激光磨削去表皮后，按照不同的黑素细胞密度进行移植。随访观察6、12和24个月患者色素恢复比率和色素匹配情况。结果 共治疗632例稳定期白癜风患者。随访6个月时，52.85%患者皮损复色面积超过90%，82.28%患者皮损复色面积超过50%，4个组间痊愈率和有效率差异无统计学意义（均P > 0.05）。随访6、12和24个月，黑素细胞接种量（5.0 ~ 7.9） × 104个/cm2组色素匹配良好率明显高于其他3组（均P < 0.05）。各组病例移植后6个月时与正常皮肤颜色色素匹配良好率均明显低于12和24个月时（均P < 0.05）；随访12个月与正常皮肤颜色色素匹配良好率与随访24个月差异均无统计学意义（均P > 0.05）。结论 自体纯培养黑素细胞移植是治疗稳定期白癜风的有效治疗手段，黑素细胞最优接种量为（5.0 ~ 7.9） × 104个/cm2，皮肤颜色色素匹配度随时间升高。 【关键词】 白癜风； 黑素细胞； 细胞移植； 细胞计数

关键词: 白癜风, 黑素细胞, 细胞移植, 细胞计数

Abstract: HONG Wei-song, FU Li-fang, WEI Xiao-dong, QIAN Guo-pei, XU Ai-e. Department of Dermatology, Third People′s Hospital of Hangzhou, Hangzhou 310009, China Corresponding author: XU Ai-e, Email: xuaiehz@msn.com 【Abstract】 Objective To evaluate the relationship between cell seeding density and clinical efficacy of autologous cultured melanocyte transplantation in the treatment of vitiligo. Methods A total of 632 patients with vitiligo were enrolled in this study, and randomly classified into 4 groups to be treated with transplantation of autologous cultured melanocytes at 4 different seeding densities respectively, i.e., （3.0 － 4.9）× 104/cm2 （n = 201）,（5.0 － 7.9） × 104/cm2 （n = 303）, （8.0 － 9.9） × 104/cm2 （n = 82）, （10.0 － 12.0） × 104/cm2 （n = 46）. Epidermal sheets were obtained by suction blister biopsy from the normal skin of the vitiligo patients, and subjected to the isolation and culture of melanocytes. After 2 to 5 passages, the cultured autologous melanocytes were transplanted at different seeding densities to vitiligous lesions, which were abraded previously by ultra-pulsed CO2 laser, of these patients. All the patients were followed for 6 － 12 months. Results At 6 months after the transplantation, 52.85% of these patients achieved more than 90% repigmentation, and 82.28% more than 50% repigmentation, with no differences in the cure rate and response rate between the 4 groups （both P < 0.05）. The percentage of patients obtaining excellent color matching was significantly higher in the group treated with transplantation of melanocytes at a seeding density of （5.0 － 7.9） × 104/cm2 than in the other 3 groups at 6, 12 and 24 months after treatment （all P < 0.05）, and higher in all the 4 groups at 12- and 24-month points compared with the 6-month point （all P < 0.05）, but no statistical difference was observed between the 12- and 24-month point in any of these groups （all P > 0.05）. Conclusions The transplantation of autologous cultured pure melanocytes is effective for the treatment of stable vitiligo with the optimal cell seeding density of melanocytes being （5.0 － 7.9） × 104/cm2, and the color matching appears to improve with time. 【Key words】 Vitiligo; Melanocytes; Cell transplantation; Cell count