窄谱中波紫外线照射对白癜风自体表皮移植的作用研究

中华皮肤科杂志 ›› 2016, Vol. 49 ›› Issue (10): 728-731.

窄谱中波紫外线照射对白癜风自体表皮移植的作用研究

史永俭,刘园园,刘瑛

山东大学第二医院皮肤科

收稿日期:2016-01-05 修回日期:2016-02-26 出版日期:2016-10-15 发布日期:2016-09-30
通讯作者: 史永俭 E-mail:syj623@163.com
基金资助:
济南青年科技明星计划

Effects of narrow?band ultraviolet B radiation on the efficacy of autologous epidermal grafting for vitiligo

Received:2016-01-05 Revised:2016-02-26 Online:2016-10-15 Published:2016-09-30

摘要/Abstract

摘要：

目的探讨自体表皮移植联合窄谱中波紫外线（NB?UVB）照射治疗白癜风的临床疗效及可能作用机制。方法 30例白癜风患者分为单纯表皮移植组和表皮移植联合NB?UVB组。用酶联免疫吸附测定检测局部皮损组织液中白细胞介素18（ IL?18）、肿瘤坏死因子α（ TNF?α）以及可溶性细胞间黏附分子1（sICAM?1）水平，并进行疗效评估。结果治疗前，单纯表皮移植组和表皮移植联合NB?UVB组局部皮损组织液中IL?18分别为（0.985 ± 0.305） μg/L和（1.008 ± 0.399） μg/L；TNF?α分别为（1.132 ± 0.313） μg/L、（1.147 ± 0.474） μg/L；sICAM?1分别为（1.215 ± 0.284） μg/L、（1.221 ± 0.432） μg/L；水平明显高于健康对照组（均P < 0.01）。表皮移植联合NB?UVB组治疗后各细胞因子水平基本恢复正常，有效率（68.9%）明显高于单纯表皮移植组（43.8%），P < 0.05。结论白癜风患者局部皮损处存在免疫异常，NB?UVB照射可以通过调节机体免疫功能提高表皮移植的成功率。

Abstract:

Shi Yongjian, Liu Yuanyuan, Liu Ying Department of Dermatology, The Second Hospital of Shandong University, Jinan 250033, China Corresponding author: Shi Yongjian, Email: syj623@163.com 【Abstract】 Objective To evaluate the clinical efficacy of autologous epidermal grafting combined with narrow-band ultraviolet B （NB-UVB） radiation for the treatment of vitiligo, and to explore their possible action mechanisms. Methods Totally, 30 patients with vitiligo were randomly and equally divided into 2 groups: epidermal grafting group treated with autologous epidermal grafting alone, and combination group treated with both autologous epidermal grafting and NB-UVB radiation. Fifteen healthy volunteers served as the healthy control group. Enzyme-linked immunosorbent assay （ELISA） was performed to detect the levels of interleukin-18 （IL-18）, tumor necrosis factor-α （TNF-α） and soluble intercellular adhesion molecule-1 （sICAM-1） in interstitial fluid from the patients before and after the treatment, as well as from the healthy controls. Therapeutic effects were evaluated after 3-month treatment. Results Before the treatment, the epidermal grafting group and combination group both showed significantly increased levels of IL-18 （0.985 ± 0.305 μg/L, 1.008 ± 0.399 μg/L, respectively） , TNF-α （1.132 ± 0.313 μg/L, 1.147 ± 0.474 μg/L, respectively） and sICAM-1 （1.215 ± 0.284 μg/L, 1.221 ± 0.432 μg/L, respectively） in interstitial fluid compared with the healthy control group （all P < 0.01）. The levels of the three cytokines in the combination group almost all returned to normal after the 3-month treatment. In addition, the combination group showed a significantly higher response rate compared with the epidermal grafting group （68.9% vs. 43.8%, P < 0.05）. Conclusion Immune abnormalities exist in local lesions of patients with vitiligo, and NB-UVB radiation can increase the success rate of epidermal grafting likely by regulating the body′s immune function.

史永俭刘园园刘瑛. 窄谱中波紫外线照射对白癜风自体表皮移植的作用研究[J]. 中华皮肤科杂志, 2016, 49(10): 728-731.

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